Comparison of Clinical Outcomes of Posterior C1-C2 Temporary Fixation without Fusion and C1-C2 Fusion for Fresh Odontoid Fractures
Guo Q, Deng Y, Wang J, Wang L, Lu X, Guo X, et al. (Neurosurgery)
In this retrospective case series, the authors compared patients with odontoid fractures undergoing posterior C1-C2 fixation using anterior odontoid screws to patients undergoing C1-C2 fixation using posterior instrumentation. In the 22 patients included in the odontoid screw group (deemed candidates for the technique and who underwent screw placement), 21 of them experienced fracture healing and motion preservation at the C1-C2 level. These 21 patients then were compared to 21 randomly selected patients who had undergone C1-C2 posterior fixation for odontoid fractures. The two groups were analyzed at the time of final follow up (varied between patients) using the visual analog scale score for neck pain and stiffness, Neck Disability Index, and 36-Item Short Form Health Survey and were analyzed for time to fracture healing. The odontoid screw group had significantly better results in all of these categories with fracture healing time being not statistically significantly different between the groups (about four and a half months on average). In patients who are candidates for odontoid screw fixation of C1-C2 with odontoid fractures and who heal well following surgery, this data suggests that these patients may have better outcomes than similar patients treated with C1-C2 fusion with posterior instrumentation.
Abstract link: http://www.ncbi.nlm.nih.gov/pubmed/26348006