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[Ventral direct screw fixation in dens fractures]
Der Orthopade
|April 1, 1991
Summary
Direct anterior screw fixation offers a fusionless treatment for odontoid fractures, simplifying care and improving outcomes. This technique requires specialized spine surgeon expertise for optimal results.
Area of Science:
- Orthopedic Surgery
- Neurosurgery
- Spinal Surgery
Background:
- Odontoid fractures, specifically Anderson and d'Alonzo types II and III, often require surgical intervention.
- Traditional spinal fracture treatments typically involve fusion and immobilization, leading to increased morbidity.
Purpose of the Study:
- To evaluate the efficacy and safety of direct anterior screw fixation for odontoid fractures.
- To highlight the advantages of fusionless osteosynthesis in the upper cervical spine.
Main Methods:
- Direct anterior screw fixation using cannulated screws over K-wires.
- Osteosynthesis with interfragmentary compression, avoiding bone grafting and fusion.
Main Results:
- The procedure offers minimal iatrogenic trauma and simple postoperative care.
- Fusionless fixation demonstrated improved functional outcomes compared to traditional methods.
- A learning curve was observed, with initial complications in 17 patients followed by 15 complication-free cases.
Conclusions:
- Direct anterior screw fixation is an effective and safe treatment for select odontoid fractures.
- This technique simplifies surgical management and enhances patient outcomes.
- Expertise in upper cervical spine surgery and osteosynthesis is crucial for successful implementation.