Comparison of two temporary fixation techniques for the treatment of type II odontoid fracture

Abstract

To evaluate and compare the clinical and radiographic results between temporary C1-C2 pedicle screw fixation and cable-dragged reduction and cantilever beam internal fixation.

Between 2010 and 2013, temporary C1-C2 pedicle screw fixation (Group P, 28 patients) and cable- dragged reduction following cantilever beam internal fixation (Group C, 33 patients) were performed on type II odontoid fracture cases. Implants were removed after fracture union.

All of the 61 surgeries were performed successfully with no iatrogenic neurological worsen. One patient in Group P detected intra-operative vertebral artery injury. All patients gained fracture union. Among the observed indexes, only blood loss in Group P (128.9 ± 73.9ml) is statistically higher than in Group C (97.3 ± 5 4.2ml).

Pedicle screw fixation carries the risk of vertebral artery injury, especially in patients with high-riding vertebral artery. Cable-dragged reduction following cantilever beam internal fixation could avoid the potential risk of vertebral injury, but it prolonged the fixed segments. We thought cable-dragged reduction following cantilever beam internal fixation could be an alternative method for treating type II odontoid fracture.