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Case Reports
. 1999 Jun;51(6):596-600; discussion 600-1.
doi: 10.1016/s0090-3019(98)00136-0.

Posterior C1-C2 Transarticular Screw Fixation in the Treatment of Displaced Type II Odontoid Fractures in the Geriatric Population--Review of Seven Cases

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Case Reports

Posterior C1-C2 Transarticular Screw Fixation in the Treatment of Displaced Type II Odontoid Fractures in the Geriatric Population--Review of Seven Cases

M Campanelli et al. Surg Neurol. .

Abstract

Background: Seven geriatric patients presented with displaced Type II odontoid fractures. All patients underwent a posterior C1-C2 transarticular fixation between November 1994 and December 1996. Ages ranged between 63 and 88 years.

Methods: Fractures were treated with placement of bilateral transarticular screws, allowing immediate fixation, except in one patient, for whom only a unilateral screw was used. An autograft interspinous strut was also placed, allowing three-point fixation. Mean follow-up was 10.6 months.

Results: Six patients received rigid fixation and developed a stable union. One patient died before any follow-up could be obtained. Two other patients died within 1 year of unrelated causes. The remaining four patients remain active and independent. One intraoperative vertebral artery injury was identified. No clinical sequalae were noted.

Conclusion: Posterior transarticular screw fixation is a reasonable option in treating these controversial fractures. Seven geriatric patients tolerated this surgery well, and were mobilized early, avoiding complications related to external immobilization.

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