The role of single odontoid screw fixation in treatment of odontoid fracture type II

Abstract Background Odontoid fractures are the most common cervical fractures specially type II. Anterior odontoid screw fixation has many advantages with low incidence of surgical complications. Purpose To evaluate the role of single odontoid screw fixation in surgical treatment of odontoid fracture type II. Study design A retrospective clinical case series. Patients and methods Twelve patients with acute traumatic odontoid fracture type II were surgically treated by anterior single odontoid screw fixation. The visual analogue scale (VAS) and neck disability index (NDI) were used to evaluate the functional outcome among our patients. Plain radiography and CT cervical spine were done in all cases preoperatively and during our period of follow-up (6 months). Preoperative MRI cervical spine was done in all cases. Results The study included 12 patients, four of them (33.3%) were females, and 8 (66.7%) were males with a mean age of 41.7 ± 11.4 years. All patients had acute traumatic odontoid fracture type II, oblique fractures in 10 (83.3%) cases, and transverse fractures in 2 (16.7%) cases. All cases operated for anterior single odontoid screw fixation. During our period of follow-up, VAS and neck disability index were improved in all cases. There were 5 cases (41.7%) with transient dysphagia. Solid fusion was achieved in all cases except in one patient (8.3%) (fibrous union). Conclusion Single odontoid screw fixation is useful and safe procedure in surgical treatment of odontoid fractures type II. Careful attention to the technical aspects of the procedure and selection of patients are essential for good outcome.