Volume 1, Number 2 (6-2015)                   jicr 2015, 1(2): 62-66 | Back to browse issues page

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Abstract:   (693 Views)

Introduction: Anterior screw fixation provides the best anatomical and functional results for type II odontoid process fracture with intact transverse ligament. The purpose of this study was to report the usefulness of single lag screw and relate our experience.

Methods: From 2008 to 2013, 37 cases of acute type II dens fracture were treated with anterior single screw fixation in our center. All patients underwent standard approach identical to the C2-C3 and using fluoroscopic guidance a Kirschner wire (K wire) was inserted at the anterior lip of C2 in a sagittal direction angled posteriorly and exited the posterior tip of odontoid. The trajectory was confirmed with two plan imaging then the final lag screw was inserted in through the guide tube.

Results: There were 26 male and 11 female patientswith type II odontoid process fracture whose ages ranged from 8 to 67 yr (mean 27.27 yr). In all cases, the screw could be successfully introduced crossing the fracture site and engaging the dens. On follow up of all cases, 100% good fusion was achieved. No case of non-:::::union::::: was observed. There were no major neurological complications. None of the patients developed operative site infection, CSF fistula, esophageal tear, submandibular fistula or hypoglossal nerve paresis. There was no screw breakage in follow-up. Transient dysphagia was present in 18 cases, which improved.
Conclusion: Anterior single lag screw fixation is a very useful method in anterior fixation for type II odontoid process fracture. This case series showed successful results also in type II odontoid fracture when treated with the single lag screw.

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Type of Study: Research | Subject: Special
Received: 2015/10/25 | Accepted: 2015/10/25 | Published: 2015/10/25