Anterior Screw Fixation in Type II Odontoid Fractures: Keys for Better Outcome in Early Experience in Developing Countries

Abstract

Introduction: Representing up to 15% of cervical injuries, odontoid type II fractures may cause spinal cord compression through atlanto-axial instability. Anterior screw fixation provides direct fracture site stability, high fusion rate and most importantly keeping cervical spine move free. We will highlight success keys in early experience for better outcome. Methods: We operated ten cases with traumatic type II odontoid fractures in neurotrauma unit, Cairo University hospitals from March 2015 till June 2017. Six males and four females were included. Preoperative MRI and dynamic CT were among the assessment criteria. Uni-planner fluoroscopy was used. Results: No post-operative deficit appeared. One screw was inserted in all cases. Immediate and 6 weeks later CT cervical spine showed stable reduced fracture site. Conclusions: Anterior odontoid screw fixation done with prior good selection of the patient and fracture shape is an effective motion preserving surgical option for type II odontoid fractures. Limited resources shouldn’t prevent starting experience especially in developing countries, but larger studies are needed.