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European Spine Journal
Published in: European Spine Journal 11/2011

01-11-2011 | Original Article

Analysis of failure following anterior screw fixation of Type II odontoid fractures in geriatric patients

Authors: Michael Osti, Helmut Philipp, Berthold Meusburger, Karl Peter Benedetto

Published in: European Spine Journal | Issue 11/2011

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Abstract

Anterior screw fixation of Type II odontoid fractures has been recommended. Only few publications analyse the mechanism of failure in geriatric patients. We reviewed 18 male and 15 female patients aged 65 and above for parameters that influence the development of postoperative loss of correction, delayed union or non-union. Patients were stratified in two groups: 21 cases in Group A (union) and 12 patients in Group B (loss of correction, delayed union, non-union, revision surgery). Statistically significant correlation (p < 0.05) could be detected between failure to heal and: (1) degenerative changes in the atlanto-odontoid joint, (2) severity of osteoporosis in the odontoid process, (3) posterior oblique fracture type, (4) suboptimal fracture reduction, (5) suboptimal position of implant following demanding intraoperative conditions, (6) quality of fracture compression and (7) severity of fracture comminution. The overall morbidity and mortality rates were 29.0 and 8.6%, respectively. Our results indicate that these factors should be addressed regarding the selection of the operative treatment method in the geriatric patient.
Literature
1.
Anderson S, Rodrigues M, Olerud C (2000) Odontoid fractures: high complication rate associated with anterior screw fixation in the elderly. Eur Spine J 9:56–60CrossRef
2.
Lakshmanan P, Jones A, Howes J, Lyons K (2005) CT evaluation of the pattern of odontoid fractures in the elderly—relationship to upper cervical spine osteoarthritis. Eur Spine J 14:78–83PubMedCrossRef
3.
Müller EJ, Wick M, Russe O, Muhr G (1999) Management of odontoid fractures in the elderly. Eur Spine J 8:360–365PubMedCrossRef
4.
Platzer P, Thalhammer G, Ostermann R, Wieland T, Vecsei V, Gaebler C (2007) Anterior screw fixation of odontoid fractures comparing younger and elderly patients. Spine 32:1714–1720PubMedCrossRef
5.
6.
White AP, Hashimoto R, Norvell DC, Vaccaro AR (2010) Morbidity and mortality related to odontoid fracture surgery in the elderly population. Spine 35:146–157CrossRef
7.
Börm W, Kast E, Richter HP, Mohr K (2003) Anterior screw fixation in Type II odontoid fractures: is there a difference in outcome between age groups? Neurosurgery 52:1089–1092PubMedCrossRef
8.
Fountas KN, Kapsalaki EZ, Karampelas I, Feltes CH, Dimopoulos VG, Machinis TG, Nikolakakos LG, Boev AN, Choudhri H, Smisson HF, Robinson JS (2005) Results of long-term follow-up in patients undergoing anterior screw fixation of type II and rostral type III odontoid fractures. Spine 30:661–669PubMedCrossRef
9.
Lennarson PJ, Mostafavi H, Traynelis VC, Walters BC (2000) Management of type II dens fractures. Spine 25:1234–1237PubMedCrossRef
10.
Apfelbaum RI, Lonser RR, Veres R, Casey A (2000) Direct anterior screw fixation for recent and remote odontoid fractures. J Neurosurg 93:227–236PubMed
11.
Harrop JS, Przybylski GJ, Vaccaro AR, Yalamanchili K (2000) Efficiacy of anterior odontoid screw fixation in elderly patients with Type II odontoid fractures. Neurosurg Focus 8:1–4
12.
Magerl F, Seeman PS (1986) Stable posterior fusion of the atlas and axis by transarticular screw fixation. In: Kehr P, Weidner A (eds) Cervical spine I. Springer, New York, pp 322–327
13.
Frangen TM, Zilkens C, Muhr G, Schinkel C (2007) Odontoid fractures in the elderly: dorsal C1/C2 fusion is superior to halo-vest immobilisation. J Trauma 63:83–89PubMedCrossRef
14.
Maak TG, Grauer JN (2006) The contemporary treatment of odontoid injuries. Spine 31:53–60CrossRef
15.
Platzer P, Vecsei V, Thalhammer G, Oberleitner G, Schurz M, Gaebler C (2008) Posterior atlanto-axial arthrodesis for fixation of odontoid non-unions. Spine 33:624–630PubMedCrossRef
16.
Aebi M, Etter C, Coscia M (1989) Fractures of the odontoid process. Treatment with anterior screw fixation. Spine 14:1065–1070PubMedCrossRef
17.
18.
Koivikko M, Kiuru MJ, Koskinen SK, Myllynen P, Santavirta S, Kivisaari L (2004) Factors associated with non-union in conservatively-treated Type II fractures of the odontoid process. J Bone Joint Surg 86B:1146–1151CrossRef
19.
Sen MK, Steffen T, Bechman L, Tsantrizos A, Reindl R, Aebi M (2005) Atlanto-axial fusion using anterior transarticular screw fixation of C1/C2. Technical innovation and biomechanical study. Eur Spine J 14:512–518PubMedCrossRef
20.
Stulik J, Vyskocil T, Sebesta P, Kryl J (2007) Atlantoaxial fixation using the polyaxial screw-rod system. Eur Spine J 16:479–484PubMedCrossRef
21.
Wilke HJ, Fischer K, Kugler A, Magerl F, Claes L, Wörsdörfer O (1992) In vitro investigations of internalfixation systems of the upper cervical spine. II. Stability of posterior atlanto-axial fixation techniques. Eur Spine J 1:191–199PubMedCrossRef
22.
Grob D, Crisco JJ 3rd, Panjabi MM, Wang P, Dvorak J (1992) Biomechanical evaluation of four different posterior atlantoaxial fixation techniques. Spine 17:480–490PubMedCrossRef
23.
Harms J, Melcher PM (2001) Posterior C1–C2 fusion with polyaxial screw and rod fixation. Spine 26:2467–2471PubMedCrossRef
Metadata
Title
Analysis of failure following anterior screw fixation of Type II odontoid fractures in geriatric patients
Authors
Michael Osti
Helmut Philipp
Berthold Meusburger
Karl Peter Benedetto
Publication date
01-11-2011
Publisher
Springer-Verlag
Published in
European Spine Journal / Issue 11/2011
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-011-1890-7

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