Atlantoaxial Fixation for Odontoid Fracture: Analysis of 124 Surgically Treated Cases.

Abstract:

OBJECTIVE:The authors analyze 124 cases with fracture of odontoid process. All patients were surgically treated by posterior atlantoaxial fixation. METHODS:There were 96 male and 28 female patients. The ages of the patients ranged from 12 to 80 years. Apart from Anderson and D'Alonzo type I (6 cases), type II (93 cases) and type III (25 cases), three sub-types of odontoid fractures were included in the classification. In type A (118 cases), there was vertical compression fracture that resulted in malalignment of the fractured odontoid process segments. Type B (49 cases) resulted when the fracture resulted in malalignment of the facets of atlas and axis. Type C (25 cases) included cases in which the fracture line involved the facet of axis. Fractures were divided into acute type when the injury was less than 3 months old (50 cases), delayed type when the injury was between 3 months to one year (34 cases) and chronic type when the injury was more than 1 year in duration (40 cases). All patients were treated with posterior atlantoaxial fixation with the techniques described in 1994 and 2004. Follow-up period ranged from 6 to 156 months (average 72 months). RESULTS:All patients improved in symptoms after surgery. There were no significant postoperative complications. CONCLUSIONS:Posterior atlantoaxial stabilization forms a safe surgical strategy for all kinds of odontoid fractures. Additional characteristics of odontoid fractures further subclassified them and assisted in surgical decision-making and in formulating the surgical strategy.

journal_name

World Neurosurg

journal_title

World neurosurgery

authors

Goel A,Jain S,Shah A,Patil A,Vutha R,Ranjan S,More S

doi

10.1016/j.wneu.2017.08.192

subject

Has Abstract

pub_date

2018-02-01 00:00:00

pages

558-567

eissn

1878-8750

issn

1878-8769

pii

S1878-8750(17)31502-4

journal_volume

110

pub_type

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