Management of Type – II Odontoid Process Fracture by Anterior Odontoid Screw Fixation (AOSF) in Young Adults: Case Series

  • SHAMS RAZA BROHI Department of Neurosurgery, People’s university of Medical and Health Sciences for Women, Nawabshah, Sindh
  • MUZAMIL DILBAR Department of Neurosurgery, People’s university of Medical and Health Sciences for Women, Nawabshah, Sindh
  • FAHMIDA ARAB MALLAH Department of Neurosurgery, People’s university of Medical and Health Sciences for Women, Nawabshah
  • SUNNY THAPA Department of Neurosurgery, People’s university of Medical and Health Sciences for Women, Nawabshah
Keywords: Odontoid fracture, Anterior odontoid screw fixation, C – Spine injuries, axis vertebra

Abstract

odontoid fracture AOSF with lag screw is the reference technique in unstable fracture. Various other treatment modalities have been described in the literature; however author finds the ASOF technique to be reasonable with less intraoperative and post-operative complications. Moreover the rate of bony fusion is also high and post-operative mobilization in case of ASOF.

Material and Methods:  This is prospective observational case series. Two cases of odontoid fractures (type II) are reported.

Results and Conclusion:  Our cases illustrated that odontoid fracture type II can successfully be managed with AOSF with good post-operative outcome. Union rate of this fracture is high with lag screw fixation (AOSF technique). Nevertheless, due to a limited number of cases author would also like to add that outcome could be better assessed in a larger group of study.

References

1. Mixter SJ, Osgood RB. IV Traumatic lesions of the atlas and axis. Ann Surg. 1910; 51 (2): 193-201.
2. Anderson LD, D’Alonzo RT. Fractures of the odontoid process of the axis. J Bone Joint Surg Am. 1974; 56: 1663-1674.
3. Saro, A., Abdelhameid, A.K. & Fadl, K.N. Surgical outcome of type II odontoid fracture, Harms technique. Egypt J Neurosurg. 2019: 34: 3.
https://doi.org/10.1186/s41984-019-0031-1
4. Hadley et al., New subtype of acute odontoid fracture (Type IIA). Neurosurgery, 1988; 22 (1 pt 1): 67-71
5. Suoma Yuan et al. The comparison of clinical outcome of fresh type II odontoid fracture treatment between anterior cannulated screw fixations a posterior instrumentation of C1-C2 without fusion: a retrospective cohort study. Journal of Orthopaedic Surgery and Research, 2018: 13: 3.
6. Lennarson et al. Management of type II dens fracture: a case control study. Spine, 2000: 1234-1237.
7. Falavigna A, Righesso O, da Silva PG, Siri CR, Daniel JW, Esteves Veiga JC, Laurindo de Azevedo GB, Yurac R, Sanchez Chavez FA, Sfreddo E, Cecchini A, do Reis MM, Riew KD, Management of Type II Odontoid Fractures: Latin American Spine Centers Experience, World Neurosurgery. 2016.
Doi: 10.1016/j.wneu.2016.10.120.
8. Greene et al. Acute Axis Fractures: Analysis of Management and Outcome in 340 Consecutive Cases. Spine. 1997; 22 (16): 1843–1852.
9. Jenkins, et al. Clinical comparison of one - and two-screw odontoid fixation. J Neurosurgery, 1998; 89: 366-370.
10. C. Eap, et al. Odontoid fractures anterior screw fixation: A continuous series of 36 cases. Orthopaedics & Traumatology: Surgery & Research, 2010; 96: 748—752.
Published
2020-07-13
Section
Case Reports