Single-screw fixation for acute Type II odontoid fracture

The management of odontoid fractures is still controversial. The main current trends of treatment are conservative management with HALO immobilization, posterior surgical fixation or anterior surgical fixation. The authors report a consecutive series of 17 cases of patients with acute Type II odontoid fracture treated between November 1994 and February 2000.

Since June 1997 anterior odontoid screw fixation was performed in nine cases. The technical aspects of the internal fusion are described.

Spinal stabilization was achieved in all patients. The postoperative neuroimaging demonstrates the successful positioning of the odontoid screw of all patients.

The success of this treatment depends on patients' selection, attention to technical operative details and adequate follow-up. Internal screw fixation gives immediate direct fixation of the fracture, offers a high rate of fusion without requiring prolonged HALO immobilization, it gives a reduction of the cervical pain and preserves the normal mobility of C1-C2.