Motion preservation in type II odontoid fractures using temporary pedicle screw fixation: a preliminary study

Eur Spine J. 2015 Apr;24(4):686-93. doi: 10.1007/s00586-014-3693-0. Epub 2014 Dec 28.

Abstract

Purpose: To assess the feasibility of temporary pedicle screw fixation for motion preservation of type II odontoid fractures unsuitable for anterior screw.

Methods: Between 2012 and 2013, temporary pedicle screw fixation was performed in 13 patients with type II odontoid fractures unsuitable for anterior screw. The patients were 10 men and 3 women with an average age of 40. The implant was removed after fracture union. Dynamic CT was performed ≥ 1 month after implant removal to evaluate atlantoaxial rotation and axial neck rotation. Literature data on axial neck rotation were obtained as a historical control.

Results: Fifty-two pedicle screws were placed successfully with satisfactory fracture reduction achieved in all patients. The average follow-up period was 14.2 months. At a mean of 9 months after the initial operation, fracture union was confirmed and implants were removed. The average total axial neck rotation was 116.5° ± 25.8° (78.2 ± 14.8 % of the historical controls). The average total atlantoaxial rotation was 34.2° ± 22.0° (27.3 ± 13.8 % of total axial neck rotation).

Conclusions: Temporary pedicle screw fixation is a feasible technique for motion preservation of type II odontoid fractures unsuitable for anterior screw.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Atlanto-Axial Joint / physiopathology*
  • Device Removal
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Fracture Fixation, Internal / instrumentation*
  • Fracture Fixation, Internal / methods
  • Fracture Healing
  • Humans
  • Male
  • Middle Aged
  • Odontoid Process / injuries*
  • Odontoid Process / surgery
  • Pedicle Screws*
  • Range of Motion, Articular
  • Spinal Fractures / surgery*
  • Treatment Outcome
  • Young Adult