Single-screw fixation for acute Type II odontoid fracture

Abstract

Background: The management of odontoid fractures is still controversial. The main current trends of treatment are conservative management with HALO immobilization, posterior surgical fixation or anterior surgical fixation. The authors report a consecutive series of 17 cases of patients with acute Type II odontoid fracture treated between November 1994 and February 2000.

Methods: Since June 1997 anterior odontoid screw fixation was performed in nine cases. The technical aspects of the internal fusion are described.

Results: Spinal stabilization was achieved in all patients. The postoperative neuroimaging demonstrates the successful positioning of the odontoid screw of all patients.

Conclusions: The success of this treatment depends on patients' selection, attention to technical operative details and adequate follow-up. Internal screw fixation gives immediate direct fixation of the fracture, offers a high rate of fusion without requiring prolonged HALO immobilization, it gives a reduction of the cervical pain and preserves the normal mobility of C1-C2.