[Anterior odontoid screw fixation using intra-operative cone-beam computed tomography and navigation]

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Surgery

Background:

• Traumatic odontoid fractures often require surgical intervention for stabilization.
• Anterior odontoid screw fixation is a common surgical technique.
• Ensuring accurate screw placement is critical for successful fusion and patient outcomes.

Purpose of the Study:

• To evaluate the efficacy and safety of using intraoperative cone-beam CT (O-arm) and stereotactic navigation for anterior odontoid screw insertion.
• To assess the accuracy of screw placement and the rate of bone fusion in patients with traumatic odontoid fractures.

Main Methods:

• Retrospective review of patients undergoing surgical treatment for traumatic odontoid fractures over 18 months.
• All procedures utilized O-arm assistance with intraoperative CT scans for screw placement verification.
• Postoperative CT scans at 3 and 6 months assessed fracture fusion.

Main Results:

• Five patients with acute type II odontoid fractures were included.
• 100% successful screw placement was achieved, confirmed by intraoperative CT.
• Bone fusion occurred in 80% of patients, with no neurological deterioration reported.

Conclusions:

• Intraoperative O-arm and navigation system provide a safe and accurate method for anterior odontoid screw fixation.
• Immediate intraoperative CT imaging allows for reliable verification of screw position.
• This technology holds promise for improving outcomes in the surgical management of odontoid fractures.