A self-designed odontoid guider for minimally invasive treatment of odontoid fractures of Anderson-D'Alonzo type II

Abstract

Objective To compare the surgical effects between minimally invasive anterior ondontoid screw fixation assisted by our self-designed odontoid guider and open anterior ondontoid screw fixation in the treatment of odontoid fractures of Anderson-D'Alonzo type Ⅱ. Methods From July 2011 to July 2016, 28 adults with odontoid fracture of Anderson-D’Alonzo type Ⅱ were treated at Department Ⅱ of Spinal Surgery, Hospital of 89 Army Group of Chinese PLA. Of them, 15 were treated by minimally invasive anterior ondontoid screw fixation assisted by our self-designed odontoid guider (guider group) while the other 13 by open anterior ondontoid screw fixation (open group). All the patients were male, aged from 31 to 59 years (average, 42.7 years). The 2 groups were compared in terms of incision length, operation time, intraoperative bleeding, intraoperative fluoroscopic frequency and hospital stay. Results There were no significant differences between the 2 groups of patients in their preoperative general data, indicating they were compatible (P>0.05). All the patients were followed up for 12 to 45 months (average, 22.1 months). The internal fixation was in good place and clinical union achieved in all the 28 patients. The incision length (2.2±0.1 cm), operation time (45.0±3.1 min), intraoperative bleeding (29.0±2.3 mL) and intraoperative fluoroscopic frequency (15.5±1.9 times) for the guider group were all significantly less than those (2.9±0.7 cm, 61.6±3.8 min, 51.6±3.9 mL and 21.7±3.2 times, respectively) for the open group (P 0.05). Conclusion In the treatment of odontoid fractures of Anderson-D'Alonzo type Ⅱ, compared with open anterior ondontoid screw fixation, the minimally invasive anterior ondontoid screw fixation assisted by our self-designed odontoid guider may lead to a smaller incision, shorter operation time, less blood loss and a lower fluoroscopic frequency. Key words: Fascia dentata; Fractures, bone; Fracture fixation, internal; Bone screws; Guider