Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
Int J Environ Res Public Health. 2021 Jul 28;18(15):7990. doi: 10.3390/ijerph18157990.
Displaced nonunited type II odontoid fracture can result in atlantoaxial instability, causing delayed cervical myelopathy. Both Magerl's C1-C2 transarticular screw fixation technique and Harms-Goel C1-C2 screw-rod segmental fixation technique are effective techniques to provide stability. This study aimed to demonstrate the results of two surgical fixation techniques for the treatment of reducible nonunited type II odontoid fracture with atlantoaxial instability. Medical records of patients with reducible nonunited type II odontoid fracture hospitalized for spinal fusion between April 2007 and April 2018 were reviewed. For each patient, specific surgical fixation, either Magerl's C1-C2 transarticular screw fixation technique augmented with supplemental wiring or Harms-Goel C1-C2 screw-rod fixation technique, was performed according to our management protocol. We reported the fusion rate, fusion period, and complications for each technique. Of 21 patients, 10 patients were treated with Magerl's C1-C2 transarticular screw fixation technique augmented with supplemental wiring, and 11 were treated with Harms-Goel C1-C2 screw-rod fixation technique. The bony fusion rate was 100% in both groups. The mean time to fusion was 69.7 (95%CI 53.1, 86.3) days in Magerl's C1-C2 transarticular screw fixation technique and 75.2 (95%CI 51.8, 98.6) days in Harms-Goel C1-C2 screw-rod fixation technique. No severe complications were observed in either group. Displaced reducible, nonunited type II odontoid fracture with cervical myelopathy should be treated by surgery. Both fixation techniques promote bony fusion and provide substantial construct stability.
可复性不愈合 II 型齿状突骨折可导致寰枢椎不稳定，引起迟发性颈髓病。Magerl 的 C1-C2 经关节螺钉固定技术和 Harms-Goel 的 C1-C2 螺钉-棒节段固定技术都是提供稳定性的有效技术。本研究旨在展示两种手术固定技术治疗可复性不愈合 II 型齿状突骨折伴寰枢椎不稳定的结果。回顾了 2007 年 4 月至 2018 年 4 月因脊柱融合住院的可复性不愈合 II 型齿状突骨折患者的病历。根据我们的管理方案，对每位患者采用特定的手术固定方法，Magerl 的 C1-C2 经关节螺钉固定技术加补充钢丝或 Harms-Goel 的 C1-C2 螺钉-棒固定技术。我们报告了每种技术的融合率、融合时间和并发症。21 例患者中，10 例采用 Magerl 的 C1-C2 经关节螺钉固定技术加补充钢丝治疗，11 例采用 Harms-Goel 的 C1-C2 螺钉-棒固定技术治疗。两组的骨融合率均为 100%。Magerl 的 C1-C2 经关节螺钉固定技术的平均融合时间为 69.7（95%CI 53.1，86.3）天，Harms-Goel 的 C1-C2 螺钉-棒固定技术为 75.2（95%CI 51.8，98.6）天。两组均未观察到严重并发症。伴有颈髓病的可复性、移位、不愈合 II 型齿状突骨折应手术治疗。两种固定技术均促进骨融合并提供坚固的结构稳定性。
