![]() ![]() The odontoid may also be retroflexed, and this has been found to be more common in individuals with the Chiari I malformation. Type II is the commonest type of dens fracture. The fully formed odontoid process is toothlike/peg shaped with a curved superior surface and deviates slightly to the left or right in approximately 1426 of the population. Type I is a rarely occurring fracture of the apical portion of the odontoid process. They classified the odontoid fractures into three categories depending on the site of the fracture line. Update on Imaging of Spinal Fixation Hardware. In 1974, Anderson and D’Alonzo published the most commonly accepted classification for odontoid fractures. Winegar B, Kay M, Chadaz T, Taljanovic M, Hood K, Hunter T. Outcomes of Patients Undergoing Anterior Screw Fixation for Odontoid Fracture and Analysis of the Predictive Factors for Surgical Failure. Odontoid Screw Fixation for Fresh and Remote Fractures. Anterior Stabilization for Acute Fractures and Non-Unions of the Dens. The Impact of Odontoid Screw Fixation Techniques on Screw-Related Complications and Fusion Rates: A Systematic Review and Meta-Analysis. Odontoid Plate Fixation Without C1–C2 Arthrodesis: Biomechanical Testing of a Novel Surgical Technique and Comparison to the Conventional Screw Fixation Procedure. Avoiding Pitfalls in Anterior Screw Fixation for Type II Odontoid Fractures. position of screws especially with relation to the following structures.The postoperative radiological report should include a description of the following features: MRI can be used to evaluate the spinal canal and the transverse alar ligament or in the setting of suspected complications 1. In addition to the exact position of implants, CT might detect complications and characterize fracture healing. An upward displacement of the odontoid process into the foramen magnum was observed in the skeletal remains of a young male unearthed from a 14th to 17th. Plain radiographs can show the position of implants and evaluate bony fusion 1. proximal screw break out through the anterior C2 vertebral body.implant loosening/proximal screw back out.postoperative radiculopathy (C2 nerve root pain).slight posteriorly angulated midline screw trajectoryĬomplications of odontoid process fixation include the following 1,3,6:.single cannulated screw insertion (young patients with good bone stock).cannulated screw insertion under fluoroscopic guidance.K-wire placement and cortex preparation.drilling under tissue protection and screw insertion.screw trajectory slight posteriorly and medially angulated with the exit in the posterior half of the odontoid tip.screw entry point determination in the inferior part of the C2 endplate.anteromedial approach with exposure of the C2 body.The procedure and technique of odontoid screw fixation involve an anterior approach. A rough overview of the surgical procedure concerning the different techniques includes the following 1: transverse alar ligament injury/disruptionĪ further contraindication to anterior odontoid screw fixation is an oblique fracture line from posterosuperior to anteroinferior, parallel to the screw trajectory.intraarticular atlantoaxial joint injuries.Contraindications of anterior odontoid screw or plate fixation include the following:
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