Pongmanee Suthipas, Sarasombath Peem, Chaiamporn Anuchit, Kaensuk Sitthikorn, Lerswanichwattana Korapuk, Liawrungrueang Wongthawat
Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Department of Orthopaedics, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand.
Trauma Case Rep. 2025 Feb 17;56:101139. doi: 10.1016/j.tcr.2025.101139. eCollection 2025 Apr.
The most common complication of an odontoid fracture type II according to the Anderson and D'Alonzo classification is nonunion. The current standard is to offer surgical treatment. Anterior odontoid screws with minimally invasive surgery can achieve an effective outcome. Full endoscopic assisted spine surgery is an option that provides good visualization for determining the correct the screw entry point. This clinical case study describes the treatment of an acute displaced fracture a 79-year-old male suffered in a motor vehicle accident using the double odontoid screw technique with full endoscopic assisted surgery. The patient had severe neck pain with ASIA grade E. Radiographic study showed a type II fracture. The patient received urgent surgical intervention using the endoscopic assisted double anterior odontoid screw fixation technique. Intraoperatively the fracture was reduced and compressed without complication using double anterior odontoid screws. Post operative radiographic analysis showed the screws were in good position and the patient participated in a rehabilitation program. The patient's symptoms were completely resolved and union of the fracture was complete at the 1-year follow up. The anterior odontoid screw technique is a challenging minimally invasive surgical technique. Full endoscopic assisted surgery is an effective and desirable technique for use with an anterior double odontoid screw. This technique could be a new option for spine surgery involving an odontoid type II fracture.
根据安德森和达隆佐分类法,II型齿状突骨折最常见的并发症是骨不连。目前的标准是提供手术治疗。采用微创手术的前路齿状突螺钉可取得有效疗效。全内镜辅助脊柱手术是一种能为确定正确的螺钉置入点提供良好视野的选择。本临床病例研究描述了一名79岁男性在机动车事故中遭受急性移位骨折后,采用全内镜辅助手术的双齿状突螺钉技术进行治疗的情况。该患者有严重的颈部疼痛,美国脊髓损伤协会(ASIA)分级为E级。影像学检查显示为II型骨折。患者接受了使用内镜辅助双前路齿状突螺钉固定技术的紧急手术干预。术中使用双前路齿状突螺钉对骨折进行了复位和加压,未出现并发症。术后影像学分析显示螺钉位置良好,患者参加了康复计划。在1年的随访中,患者症状完全缓解,骨折完全愈合。前路齿状突螺钉技术是一项具有挑战性的微创手术技术。全内镜辅助手术是一种用于双前路齿状突螺钉的有效且理想的技术。该技术可能是涉及II型齿状突骨折的脊柱手术的一种新选择。