Abstract
Anterior screw fixation (ASF) in selected odontoid fractures is a very effective and well-accepted treatment option. Although the surgical approach and the fracture fixation itself are easy, there are a number of possible pitfalls any surgeon has to know about.
The ideal indication for ASF is type II fracture according to the classification of Anderson/D’Alonzo. Patient habitus has to be taken in consideration as the accessibility to the upper cervical spine might be limited. Careful closed reduction under image intensifier control is mandatory. Most of the authors recommend one or two 3.5–4 mm cannulated screws.
After surgery, an external brace for at least 6 weeks is recommended. Radiological follow-up after surgery, 6 and 12 weeks, is necessary. In case of a non-union with clinical deterioration, an additional posterior atlantal-axial fixation and fusion is an option.
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Bibliography
Anderson LD, D’Alonzo RT. Fracture of the odontoid process of the axis. J Bone Joint Surg Am. 1974;56:1663–74.
Böhler J. Zugschraubenosteosynthese von Frakturen des Dens axis. Unfallheilkunde. 1981;84:221–3.
Aebi M, Etter C, Coscia M. Fractures of the odontoid process. Treatment with anterior screw fixation. Spine. 1989;14:1065–70.
Etter C, Coscia M, Jaberg H, Aebi M. Direct anterior fixation of the dens fracture with a cannulated screw system. Spine. 1991;16:25–32.
Montesano PX, Anderson PA, Schlehr F, Thalgott JS, Lowrey G. Odontoid fractures treated by anterior odontoid screw fixation. Spine. 1991;16:33–7.
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Kathrein, A. (2019). Odontoid Fracture: Anterior Screw Fixation. In: Koller, H., Robinson, Y. (eds) Cervical Spine Surgery: Standard and Advanced Techniques. Springer, Cham. https://doi.org/10.1007/978-3-319-93432-7_22
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DOI: https://doi.org/10.1007/978-3-319-93432-7_22
Publisher Name: Springer, Cham
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