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Archives of Orthopaedic and Trauma Surgery
Published in: Archives of Orthopaedic and Trauma Surgery 12/2013

01-12-2013 | Trauma Surgery

Anterior screw fixation for an odontoid fracture using an Acutrak 4/5 screw: a case report

Authors: Juichi Tonosu, Kenichi Watanabe, Hiroaki Abe, Akiro Higashikawa, Shinya Kato, Koji Yamada

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 12/2013

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Abstract

The direct anterior screw fixation of odontoid fractures by a single cancellous screw, especially for osteoporotic vertebrae, has a potential risk of leading to insufficient stability and implant failures. We experienced good results following surgery using a single Acutrak 4/5 screw to obtain sufficient stability for an odontoid fracture in a patient with osteopenia. The screw is a cannulated self-tapping headless screw and has a tapered profile and full threads with variable pitches, and it can yield sufficient compression force as the screw is inserted. The preoperative severe neck pain of the patient was diminished immediately after the surgery. The patient achieved bone union in a short time and had a good clinical result for at least 3 years. Some biomechanical studies showed that the compression force of Acutrak standard screws was stronger than that of both 4.0-mm cancellous screws inserted with the lag screw technique and Herbert screws, and other studies showed that the compression force of Acutrak 4/5 screws was equivalent to that of 4.5-mm cortical screws. However, there has been no clinical report of surgery using an Acutrak 4/5 screw for odontoid fractures. This is the first clinical report of fixation by an Acutrak 4/5 screw.
Literature
1.
Anderson LD, D’Alonzo RT (1974) Fractures of the odontoid process of the axis. J Bone Joint Surg Am 56(8):1663–1674PubMed
2.
Andersson S, Rodrigues M, Olerud C (2000) Odontoid fractures: high complication rate associated with anterior screw fixation in the elderly. Eur Spine J 9(1):56–59PubMedCrossRef
3.
Bueno AC, Galuppo LD, Taylor KT, Jensen DG, Stover SM (2003) A biomechanical comparison of headless tapered variable pitch and AO cortical bone screws for fixation of a simulated slab fracture in equine third carpal bones. Vet Surg 32(2):167–177PubMedCrossRef
4.
Chang KW, Liu YW, Cheng PG, Chang L, Suen KL, Chung WL, Chen UL, Liang PL (1994) One Herbert double-threaded compression screw fixation of displaced type II odontoid fractures. J Spinal Disord 7(1):62–69PubMedCrossRef
5.
Chapman J, Smith JS, Kopjar B, Vaccaro AR, Arnold P, Shaffrey CI, Fehlings MG (2013) The AOSpine North America geriatric odontoid fracture mortality study: a retrospective review of mortality outcomes for operative versus non-operative treatment in 322 patients with long-term follow-up. Spine 38(13):1098–1104PubMedCrossRef
6.
Collins I, Min WK (2008) Anterior screw fixation of type II odontoid fractures in the elderly. J Trauma 65(5):1083–1087PubMedCrossRef
7.
Eddy AL, Galuppo LD, Stover SM, Taylor KT, Jensen DG (2004) A biomechanical comparison of headless tapered variable pitch compression and ao cortical bone screws for fixation of a simulated midbody transverse fracture of the proximal sesamoid bone in horses. Vet Surg 33(3):253–262PubMedCrossRef
8.
Faran KJ, Ichioka N, Trzeciak MA, Han S, Medige J, Moy OJ (1999) Effect of bone quality on the forces generated by compression screws. J Biomech 32(8):861–864PubMedCrossRef
9.
Gregg EW, Kriska AM, Salamone LM, Roberts MM, Anderson SJ, Ferrell RE, Kuller LH, Cauley JA (1997) The epidemiology of quantitative ultrasound: a review of the relationships with bone mass, osteoporosis and fracture risk. Osteoporos Int 7(2):89–99PubMedCrossRef
10.
Gregory JJ, Mohil RS, Ng AB, Warner JG, Hodgson SP (2008) Comparison of Herbert and Acutrak screws in the treatment of scaphoid non-union and delayed union. Acta Orthop Belg 74(6):761–765PubMed
11.
Harrop JS, Hart R, Anderson PA (2010) Optimal treatment for odontoid fractures in the elderly. Spine 35(21 Suppl):S219–S227PubMedCrossRef
12.
Hausmann JT, Mayr W, Unger E, Benesch T, Vécsei V, Gäbler C (2007) Interfragmentary compression forces of scaphoid screws in a sawbone cylinder model. Injury 38(7):763–768PubMedCrossRef
13.
Hénaux PL, Cueff F, Diabira S, Riffaud L, Hamlat A, Brassier G, Morandi X (2012) Anterior screw fixation of type IIB odontoid fractures in octogenarians. Eur Spine J 21(2):335–339PubMedCrossRef
14.
Hou Y, Yuan W, Wang X (2011) Clinical evaluation of anterior screw fixation for elderly patients with type II odontoid fractures. J Spinal Disord Tech 24(8):E75–E81PubMed
15.
Jeanneret B, Vernet O, Frei S, Magerl F (1991) Atlantoaxial mobility after screw fixation of the odontoid: a computed tomographic study. J Spinal Disord 4(2):203–211PubMedCrossRef
16.
Koller H, Acosta F, Forstner R, Zenner J, Resch H, Tauber M, Lederer S, Auffarth A, Hitzl W (2009) C2-fractures: part II. A morphometrical analysis of computerized atlantoaxial motion, anatomical alignment and related clinical outcomes. Eur Spine J 18(8):1135–1153PubMedCrossRef
17.
Koller H, Resch H, Acosta F, Zenner J, Schwaiger R, Tauber M, Forstner R, Lederer S, Auffarth A, Hitzl W (2010) Assessment of two measurement techniques of cervical spine and C1-C2 rotation in the outcome research of axis fractures: a morphometrical analysis using dynamic computed tomography scanning. Spine 35(3):286–290PubMedCrossRef
18.
Konieczny, Gstrein A, Müller EJ (2012) Treatment algorithm for dens fractures: non-halo immobilization, anterior screw fixation, or posterior transarticular C1-C2 fixation. J Bone Joint Surg Am 94(19):e144(1–6)CrossRef
19.
Lee SH, Sung JK (2006) Anterior odontoid fixation using a 4.5-mm Herbert screw: the first report of 20 consecutive cases with odontoid fracture. Surg Neurol 66(4):361–366PubMedCrossRef
20.
Magee W, Hettwer W, Badra M, Bay B, Hart R (2007) Biomechanical comparison of a fully threaded, variable pitch screw and a partially threaded lag screw for internal fixation of Type II dens fractures. Spine 32(17):E475–E479PubMedCrossRef
21.
Marshall D, Johnell O, Wedel H (1996) Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. BMJ 312(7041):1254–1259PubMedCrossRef
22.
McBride AD, Mukherjee DP, Kruse RN, Albright JA (1995) Anterior screw fixation of type II odontoid fractures. A biomechanical study. Spine 20(17):1855–1859PubMedCrossRef
23.
Nakamaru K, Vernon H, Aizawa J, Koyama T, Nitta O (2012) Crosscultural adaptation, reliability, and validity of the Japanese version of the neck disability index. Spine (Phila Pa 1976) 37(21):E1343–E1347CrossRef
24.
Osti M, Philipp H, Meusburger B, Benedetto KP (2011) Analysis of failure following anterior screw fixation of Type II odontoid fractures in geriatric patients. Eur Spine J 20(11):1915–1920PubMedCrossRef
25.
Pal D, Sell P, Grevitt M (2011) Type II odontoid fractures in the elderly: an evidence-based narrative review of management. Eur Spine J 20(2):195–204PubMedCrossRef
26.
Patel AA, Lindsey R, Bessey JT, Chapman J, Rampersaud R (2010) Spine trauma study group. Surgical treatment of unstable type II odontoid fractures in skeletally mature individuals. Spine 35(21 Suppl):S209–S218PubMedCrossRef
27.
Wheeler DL, McLoughlin SW (1998) Biomechanical assessment of compression screws. Clin Orthop Relat Res 350:237–245PubMedCrossRef
Metadata
Title
Anterior screw fixation for an odontoid fracture using an Acutrak 4/5 screw: a case report
Authors
Juichi Tonosu
Kenichi Watanabe
Hiroaki Abe
Akiro Higashikawa
Shinya Kato
Koji Yamada
Publication date
01-12-2013
Publisher
Springer Berlin Heidelberg
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 12/2013
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-013-1870-y

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