Posterior Reduction and Temporary Fixation Through Intermuscular Approach for Odontoid Fracture

Area of Science:

• Orthopedic surgery
• Spinal surgery
• Traumatology

Background:

• Posterior atlantoaxial fusion for odontoid fractures can cause C1-C2 motion loss.
• Posterior reduction and temporary fixation (PRTF) via an open approach avoids this motion loss.
• The effect of PRTF using an intermuscular approach on C1-C2 rotation in fresh odontoid fractures is not well-established.

Purpose of the Study:

• To assess the preservation of C1-C2 rotational motion after PRTF through an intermuscular approach for odontoid fractures.
• To evaluate the clinical outcomes and complications associated with this minimally invasive technique.

Main Methods:

• Retrospective review of 31 patients with odontoid fractures treated with PRTF via an intermuscular approach.
• Data collected included operative details, ambulation time, complications, and functional scores (JOA, VAS).
• C1-C2 rotation was measured 1 month after instrumentation removal.

Main Results:

• All 31 patients achieved fracture healing and instrumentation removal.
• Post-removal C1-C2 rotation averaged 35.6° ± 4.8°, with improved patient satisfaction.
• No significant changes in JOA or VAS scores were noted; no osteoarthritis or perioperative complications occurred.

Conclusions:

• PRTF through an intermuscular approach is a suitable salvage treatment for odontoid fractures when anterior fixation fails or is contraindicated.
• This minimally invasive technique effectively preserves the rotational function of the atlantoaxial complex.
• The procedure demonstrates good clinical outcomes and a low complication rate.