![]() Ivancic, Paul C Beauchman, Naseem N Mo, Fred Lawrence, Brandon DĪn in vitro biomechanical study of halo-vest and odontoid screw fixation of Type II dens fracture. A prospective randomised controlled trial is recommended.īiomechanics of halo-vest and dens screw fixation for type II odontoid fracture. While most authors agree that cervical immobilisation yields satisfactory results for type I and III fractures in the elderly, the optimal management for type II fractures remain unsolved. There is insufficient evidence to establish a standard or guideline for odontoid fracture management in elderly. Lately, the posterior cervical (Goel-Harms) construct has also gained popularity amongst surgeons. In recent years several authors have claimed satisfactory results with anterior odontoid screw fixation while others have argued that this may lead to increased complications in this age group. Significant variability was found in the literature regarding mortality and morbidity rates in patients treated with and without halo vest immobilisation. There were two class II studies and the remaining were class III. One-hundred twenty-six articles were reviewed. Studies in patients aged 65 years with a minimum follow-up of 12 months were selected. ![]() Case reports and review articles were excluded although some were referred to in the discussion. The search was supplemented by cross-referencing between articles. A search of the English language literature from January 1970 to date was performed using Medline and the following keywords: odontoid, fractures, cervical spine and elderly. The objective of the study was to evaluate the published literature and determine the current evidence for the management of type II odontoid fractures in elderly. The best treatment remains unclear because of the morbidity associated with prolonged cervical immobilisation versus the risks of surgical intervention. There is uncertainty regarding the consequences of non-union. Type II odontoid fractures in the elderly: an evidence-based narrative review of management.Ĭonsiderable controversy exists regarding the optimal management of elderly patients with type II odontoid fractures. ![]() While transoral intraoperative reduction of a partially displaced odontoid fracture has previously been described, the authors present the first case utilizing this technique in the treatment of a completely dislocated type II odontoid fracture. ![]() In this report, the authors present the case of a patient with a locked type II odontoid fracture treated by anterior screw fixation facilitated by closed transoral and posterior cervical manual reduction. Piedra, Mark P Hunt, Matthew A Nemecek, Andrew NĮarly fixation of type II odontoid fractures has been shown to provide high rates of long-term stabilization and osteosynthesis. In conclusion, we suggest that Ozer's technique may help to increase the fusion capacity for osteoporotic type II odontoid fractures.Īnterior screw fixation of a dislocated type II odontoid fracture facilitated by transoral and posterior cervical manual reduction. However, the radiological results showed 100% fusion for Ozer's screw fixation technique and 83% fusion for the classical screw fixation technique. There was no difference regaring the clinical features of the groups. We have also compared (radiologically and clinically) the classical anterior transodontoid screw fixation (group II: 6 cases) and Ozer's transodontoid screw fixation technique (group I: 5 cases) retrospectively. We have divided 11 patients in two groups as classical and Ozer's technique. Eleven osteoporotic type II odontoid fracured patients were presented in this article. The nonunion of type II odontoid fractures is still a major problem especially in elderly and osteoporotic patients. Management of Type II Odontoid Fracture for Osteoporotic Bone Structure: Preliminary Report.Ĭosar, Murat Ozer, A Fahir Alkan, Bahadır Guven, Mustafa Akman, Tarık Aras, Adem Bozkurt Ceylan, Davut Tokmak, MehmetĪnterior transodontoid screw fixation technique is generally chosen for the management of type II odontoid fractures.
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