Treatment of Anderson Type II Odontoid Fracture in Elderly Patients by Posterior Pedicle Screw Fixation Combined with Iliac Bone Grafting
- 1 Department of Orthopedics, Tianyou Hospital Affiliated to Wuhan University of Science & Technology, Wuhan, China
- 2 Department of Orthopedics, Tianyou Hospital Affiliated to Wuhan University of Science & Technology, Wuhan, China
- 3 Department of Orthopedics, Tianyou Hospital Affiliated to Wuhan University of Science & Technology, Wuhan, China
- 4 Department of Surgery, College of Medicine, Wuhan University of Science and Technology, Wuhan, China
Abstract
O bj ectives: To explore the treatment and related prognosis of elderly patients with Anderson II odontoid fracture with posterior pedicle screw fixation combined with iliac bone grafting. Methods: Retrospective analysis of 17 cases of elderly patients with Anderson II odontoid fracture who underwent posterior pedicle screw fixation combined with iliac bone grafting from January 2013 to December 2016. 17 patients had a history of trauma before surgery, and they all have varying degrees of atlantoaxial instability or subluxation and varying degrees of neck occipital pain and limited mobility. Result: No spinal cord or vertebral artery injury occurred during surgery. Follow-up information is complete. The follow-up period was 6 to 48 months (mean 27.4 ± 12.4 months). Postoperative imaging review prompted a good reduction of cervical spine, stable sequence; no pedicle screw loosening, fracture, iliac bone graft at the location of the situation, odontoid fracture and bone healing at the good, the patient after cervical rotation are limited to varying degrees. Conclusion: Posterior pedicle screw fixation combined with iliac bone grafting in elderly patients with Anderson II odontoid fracture can achieve good stability, and the prognosis is good, but long-term cervical rotation function may be affected to varying degrees.
- Anderson, L.D. and D’Alonzo, R.T. (1974) Fractures of the Odontoid Process of the Axis. The Journal of Bone and Joint Surgery, 56, 1663-1674. https://doi.org/10.2106/00004623-197456080-00017
- Huybregts, J.G., Jacobs, W.C. and Vleggeert-Lankamp, C.L. (2013) The Optimal Treatment of Type II and III Odontoid Fractures in the Elderly: A Systematic Review. European Spine Journal, 22, 1-13. https://doi.org/10.1007/s00586-012-2452-3
- Kim, S.K., Shin, J.J., Kim, T.H., et al. (2011) Clinical Outcomes of Halo-Vest Immobilization and Surgical Fusion of Odontoid Fractures. Journal of Korean Neurosurgical Society, 50, 17-22. https://doi.org/10.3340/jkns.2011.50.1.17
- Denaro, V., Papalia, R., Di Martino, A., et al. (2011) The Best Surgical Treatment for Type II Fractures of the Dens Is Still Controversial. Clinical Orthopaedics and Related Research, 469, 742-750. https://doi.org/10.1007/s11999-010-1677-x
- Grauer, J.N., Shafi, B., Hilibrand, A.S., et al. (2005) Proposal of a Modified, Treatment-Oriented Classification of Odontoid Fractures. The Spine Journal, 5, 123-129. https://doi.org/10.1016/j.spinee.2004.09.014
- David, G. and Andrew, S. (2002) ABC of Spinal Cord Injury. BMJ Publishing Group, London.
- Holds Worth, P. (1970) Fractures, Dislocations and Fractures-Dislocations of the Spine. The Journal of Bone and Joint Surgery, 52, 1534. https://doi.org/10.2106/00004623-197052080-00002
- Dan, J., Zou, J., Shao, Y., et al. (2017) Treatment of Odontoid Fracture with Atlantoaxial Instability by Internal Fixation of Posterior Cruciate Bar System. Chinese Journal of Bone and Joint Injury, 32, 57-58.
- Tao, C., Ni, B., Wang, J., et al. (2006) Clinical Study of Delayed Odontoid Fracture Associated with Delayed Spinal Cord Injury. Chinese Journal of Orthopedics and Traumatology, 8, 1135-1138.
- Zhou, Z., Zhu, Y. and Xie, Y. (2013) Treatment of Traumatic Unstable Type II Odontoid Fracture with Posterior Screw Fixation. Journal of Clinical Orthopedics, 16, 605-607.
- Ren, H., Wang, J., Chen, J., et al. (2014) Treatment of Odontoid Fracture with Anterior Cervical Hollow Screw Fixation. Chinese Journal of Spine and Spinal Cord, 16, 817-819.
- Tan, M., Wang, H., Wang, Y., et al. (2003) Morphometrie Evaluation of Screw Fixation in Atlas via Posterior Arch and Lateral Mass. Spine, 28, 888-895. https://doi.org/10.1097/01.BRS.0000058719.48596.CC