Surgical Management of Type II Odontoid Fractures

Özet

Introduction: Type II fractures are the most common odontoid fractures. This study is a retrospective evaluation of surgically treated type II odontoid fracture cases. Methods: The parameters studied were age, gender, and characteristics of the fracture, such as degree of odontoid displacement, displacement of the odontoid relative to the body of the C2, anatomy of the fracture line, and the distance between fragments. The cases of 19 patients with a type II odontoid fracture were analyzed. Results: Anterior odontoid screw fixation (n=6, 31.6%), posterior cervical atlantoaxial instrumented fusion (n=7, 36.8%), and occipitocervical fusion (n=6, 31.6%) were performed. The fracture line was posterior oblique in 11 (58%), anterior oblique in 4 (21%), and horizontal in 4 (21%) patients. Anterior and posterior displacement of the odontoid was detected in 12 (63.2 ) and 7 (36.8%) patients, respectively. Discussion and Conclusion: Surgical treatment of type II odontoid fracture is still controversial. The appropriate approach should be determined based on the clinical and radiological characteristics of the patient. It was observed that the fracture fragment was displaced posteriorly in all patients. The distance between the fracture fragment and the C2 was smaller in those treated with an anterior approach.