Istinye University School of Medicine, VM Medical Park Hospital Bursa, Department of Neurosurgery, Bursa, Turkey.
Turk Neurosurg. 2022;32(5):793-801. doi: 10.5137/1019-5149.JTN.36245-21.2.
To examine whether there was an improvement in the displaced fracture line in the follow-up, in which Anterior odontoid screw fixation (AOSF) was performed without manipulation and to determine the "displacement angle range" in which AOSF was possible.
A total of 11 patients with the diagnosis of type II odontoid fracture who underwent AOSF without manipulation were analyzed retrospectively. A control group of 30 cases was formed and odontoid related angle measurements were performed on cervical computed tomographies (CT) of the control group and the patients who were operated.
In 6 of 7 cases in the posterior-displaced group along with all cases in the anterior-displaced group, it was determined that the displacement angles returned to the normal range in the 1st year follow-up. In 1 case having posterior displacement with posterior longitudinal ligament (PLL) damage, it was observed that the displacement angle improved to the normal range significantly, but the displacement continued.
AOSF is a minimally invasive, safe and effective method in patients with displaced type II odontoid fracture, which is between the median odontoidobasal angle range of 100°-134°, whose PLL is preserved, and which cannot be manipulated.
探讨在不进行手法复位的情况下,经前路齿状突螺钉固定(AOSF)后,随访时齿突骨折线的移位是否得到改善,并确定 AOSF 可能的“移位角度范围”。
回顾性分析了 11 例未经手法复位而行 AOSF 治疗的 II 型齿突骨折患者。并设立了对照组,对对照组和手术患者的颈椎 CT 进行了齿突相关角度测量。
在沿后路移位的 7 例患者中,有 6 例和所有前移位组患者在前 1 年随访时,确定其移位角度恢复到正常范围。在 1 例存在后路移位并伴有后纵韧带(PLL)损伤的患者中,观察到其移位角度显著改善至正常范围,但仍存在持续移位。
对于 II 型齿突骨折,在保留 PLL 的情况下,AOSF 是一种微创、安全且有效的方法,适用于在 100°-134°的中位齿突基底线角度范围内且不能进行手法复位的患者。