Anterior Screw Fixation for Odontoid Fractures - A Case Series

Fractures of the odontoid process are common cervical spine injuries, accounting for 10-20% of all cervical spine fractures. Anterior screw fixation of odontoid fractures is an osteosynthetic technique that can give immediate stability and preserve normal mobility.

The study was conducted in Government Mohan Kumaramangalam Medical college in the period 2017-2020. Five patients with Anderson and D'Alonzo type II odontoid Fractures were included in the study. Through anterior approach, using a horizontal skin incision, a K wire is inserted from the inferior edge of C2 through the incision and impacted into the odontoid process. A cannulated screw with non-threaded proximal shaft is inserted and tightened firmly to allow the distal fragment to compress on the body of C2. All the patients were reviewed postoperatively at 3, 6, and 12 months. Out of the five patients, all the patients had successful anatomical union at the end of 16 weeks. No neurological sequelae were reported.

Anterior screw fixation provides a reasonable approach to odontoid fractures. Posterior stabilization using multiple techniques has been described with good union rates but has several disadvantages. Anterior screw fixation provides direct fracture fixation without the need for bone grafts. In addition, it reduces post-operative discomfort and length of hospital stay.

Anterior odontoid screw fixation was associated with relatively low complication rates and a high union rate in our study. We conclude that this shall be the preferred treatment method for Type II odontoid fractures.