Neck pain and functional state were evaluated by VAS for pain and neck disability index. Preoperative evaluationĪll patients were subjected to full clinical history and examination (general and neurological). Additionally, the co-authors had neither financial nor non-financial competing interest to report. Patients’ consents for participation and for publication were not applicable. An approval from the research ethics committee of the Faculty of Medicine Tanta University was obtained on December 26, 2018. ![]() Patients were admitted and operated upon in the Department of Neurosurgery, Tanta University Hospital during the period from August 2015 to February 2018.Īll patient’s data, diagnosis, and treatment outcomes are confidentially kept private, and patients are presented by specific codes. We excluded from this study patients with odontoid fracture which extended from the anteroinferior of dens to posterosuperior, atlanto-axial dislocation, rupture of the transverse ligament, fracture of C 2 body, chronic odontoid fracture, and patients with short neck or Barrel chest.Īll patients were surgically treated by single anterior odontoid screw fixation. The duration of symptoms ranged between 1 and 6 days with a mean duration of 3.08☒.02 days. the age ranged between 25 and 65 years with a mean age of 41.7☑1.4 years. There were 8 (66.7%) males and 4 (33.3%) females with a male-to-female ratio of 2:1. This study was conducted on 12 patients with acute traumatic odontoid fractures type II (Grauer type IIB), included 10 patients (83.3%) with oblique fractures extended from the antero-superior of dens to posteroinferior portion, and two patients (16.7%) with transverse fractures. This is a retrospective clinical case series study to evaluate the role of single odontoid screw fixation in surgical treatment of odontoid fracture type II. This procedure achieves immediate stabilization, maintains rotation of C 1 on C 2, and it has low incidence of complications with good fusion rates. Nakanishi in and Bohler in introduced the anterior screw fixation for surgical treatment of odontoid fracture type II. It is, however, associated with high rates of morbidity and mortality and also resulted in decreased cervical motion specially axial rotation. Posterior C 1–C 2 fixation is the traditional method for surgical treatment of odontoid fractures with good fusion rates ranged from 92.8 to 100%. Įxternal immobilization with a cervical collar or halo vest is usually used for non-surgical treatment of odontoid fractures type II with good healing rates from 37 to 75% but it is associated with mortality rates from 26 to 47% due to prolonged external immobilization which resulted in many respiratory related complications specially in elderly patients. Type I and III fractures are usually stable and do not need surgery but controversy remains about the ideal treatment for type II fracture. Odontoid fractures are classified into three types according to the fracture site: Type I: the fracture line traverses the odontoid tip above the transverse ligament, type II: the fracture line traverses the odontoid base (the most common type), and type III: fracture includes the body of C 2. Careful attention to the technical aspects of the procedure and selection of patients are essential for good outcome. Single odontoid screw fixation is useful and safe procedure in surgical treatment of odontoid fractures type II. Solid fusion was achieved in all cases except in one patient (8.3%) (fibrous union). There were 5 cases (41.7%) with transient dysphagia. ![]() During our period of follow-up, VAS and neck disability index were improved in all cases. All cases operated for anterior single odontoid screw fixation. All patients had acute traumatic odontoid fracture type II, oblique fractures in 10 (83.3%) cases, and transverse fractures in 2 (16.7%) cases. ![]() The study included 12 patients, four of them (33.3%) were females, and 8 (66.7%) were males with a mean age of 41.7 ± 11.4 years. Preoperative MRI cervical spine was done in all cases. Plain radiography and CT cervical spine were done in all cases preoperatively and during our period of follow-up (6 months). The visual analogue scale (VAS) and neck disability index (NDI) were used to evaluate the functional outcome among our patients. Twelve patients with acute traumatic odontoid fracture type II were surgically treated by anterior single odontoid screw fixation. Study designĪ retrospective clinical case series. To evaluate the role of single odontoid screw fixation in surgical treatment of odontoid fracture type II. Anterior odontoid screw fixation has many advantages with low incidence of surgical complications. Odontoid fractures are the most common cervical fractures specially type II.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |