A new transodontoid fixation technique for delayed type II odontoid fracture: technical note

Surg Neurol. 2009 Jan;71(1):121-5; discussion 125. doi: 10.1016/j.surneu.2007.09.027. Epub 2008 Mar 4.


Background: A different transodontoid screw fixation technique was studied in delayed type II odontoid fractures. This study presents observations on a different transodontoid fixation technique to remove and decrease the amount of sclerotic layers to accelerate the fusion process after the operation.

Methods: Ten cases of chronic type II odontoid fractures were operated on via transodontoid screw fixation between 2000 and 2007 which were admitted 6 weeks or later after the trauma. Four of these 10 delayed patients were operated on using a new anterior transodontoid screw fixation technique, whereas the other 6 delayed patients were operated on using classical anterior transodontoid screw fixation.

Results: Four delayed cases with type II odontoid fracture operated on via this new technique had good results throughout the minimum 38 months' follow-up period. We did not observe nonunion, infection, and/or other complications such as vascular or brain-stem injury.

Conclusion: Transodontoid screw fixation should be considered as a preferable treatment modality. This surgical intervention may be an alternative to conservative treatment even for cases with delayed type II odontoid fractures.

MeSH terms

  • Accidents, Traffic
  • Adult
  • Bone Screws
  • Female
  • Fractures, Bone / diagnostic imaging
  • Fractures, Bone / surgery*
  • Humans
  • Male
  • Middle Aged
  • Odontoid Process / diagnostic imaging
  • Odontoid Process / injuries*
  • Odontoid Process / surgery*
  • Orthopedic Fixation Devices*
  • Orthopedic Procedures / methods*
  • Sclerosis / pathology
  • Sclerosis / surgery
  • Tomography, X-Ray Computed