Esparza PJA

Language: Spanish
References: 24
Page: 18-24
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ABSTRACT

Introduction: The odontoid process is a superior bone element, protruding from the body of the second cervical vertebra C2. The atlas rotates around the odontoid process to provide the single largest component of lateral rotation of the cervical spine. Odontoid fractures are relatively common fractures of the C2 vertebral body that can be seen in low-energy falls in older patients and in high-energy traumatic injuries in young patients. Objective: To analyze the associated morbidity and mortality, prognosis and treatment of patients with fracture of the odontoid process in the West in a high-concentration hospital and treatment updates. Material and methods: Study design: cases and controls. Retrospective analysis with diagnosis of type II odontoid process fracture. Conservative treatment vs. surgical anterior fixation or posterior instrumentation is evaluated. For qualitative variables, frequencies and percentages are used. For quantitative variables, means and standard deviations will be used. Inferential statistics: χ² and fisher test. Any value of p. Results: 29 patients were identified who met the inclusion criteria, of which 93.1% (27 patients) were classified as Anderson and D'Alonzo type II and 6.9% (two patients) as Anderson and D'Alonzo type III. The mean age of the patients was 50.93 ± 20.90 years. Conclusions: Surgical treatment in patients with odontoid fracture has a higher rate of success in the resolution of patients with this pathology but does not modify the associated morbidity and mortality rate.

REFERENCES

1. AlEissa SI, Alhandi AA, Bugis AA, Alsalamah RK, Alsheddi A, Almubarak AK, AlAssiri SS, Konbaz FM. The incidence of odontoid fractures following trauma in a major trauma center, a retrospective study. J Craniovert Jun Spine. 2020; 11: 71-74.

2. Marchesi DG. Current management of odontoid fractures. Indian Journal of Neurotrauma. 2005; 2: 3-6.

3. Gehweiler D, Wahnert D, Meier N, Spruit M, Raschke MJ, Richards RG, et al. Computational anatomy of the dens axis evaluated by quantitative computed tomography: Implications for anterior screw fixation. J Orthop Res. 2017; 35 (10): 2154-2163.

4. Terrence D. Julien, Bruce Frankel, Vincent C. Traynelis, Timothy C. Ryken. Evidence-based analysis of odontoid fracture management. Neurosurg Focus. 2000; 8 (6): 1-6.

5. Tekdemir I. Anatomical study of axis for odontoid screw thickness, length and angle. Eur Spine J. 2009; 18: 271-275.

6. Shousha M, Alhashash M, Allouch H, Boehm H. Surgical treatment of type II odontoid fractures in elderly patients: a comparison of anterior odontoid screw fixation and posterior atlantoaxial fusion using the Magerl-Gallie technique. Eur Spine J. 2019; 3-9.

7. Falavigna A, Righesso O, da Silva PG, Siri CR, Daniel JW, Esteves Veiga JC, et al. Management of type II odontoid fractures: experience from latin american spine centers. World Neurosurg. 2017; 98: 673-681.

8. Maak TG, Grauer JN. The contemporary treatment of odontoid injuries. Acta Orthop. Belg. 2018; 84: 108-115.

9. Watanabe M, Sakai D, Yamamoto Y. Analysis of predisposing factors in elderly people with type II odontoid fracture. Spine J. 2013; 14 (6): 861-866.

10. Carvalho AD, Figueiredo J, Schroeder GD, Vaccaro AR, Rodrigues-Pinto R. Odontoid fractures: a critical review of current management and future directions. Clin Spine Surg. 2019; 32 (8): 313-323.

11. Iyer S, Hurlbert RJ, Albert TJ. Management of odontoid fractures in the elderly: a review of the literature and an evidence-based treatment algorithm. Neurosurgery. 2018; 82 (4): 419-430.

12. Hubner AR, De Freitas Spinelli L, Magadiel Klaus A. Decisión en el tratamiento de las fracturas del odontoides. Coluna/Columna. 2010; 9 (1): 43-48.

13. Joestl J, Lang N, Bukaty A, Platzer P. A comparison of anterior screw fixation and halo immobilisation of type II odontoid fractures in elderly patients at increased risk from anaesthesia. Bone Jt J. 2016; 98-B (9): 1222-1226.

14. Lvov I, Grin A, Talypov A, Godkov I, Kordonskiy A, Khushnazarov U, et al. The impact of odontoid screw fixation techniques on screw-related complications and fusion rates: a systematic review and meta-analysis. Eur Spine J. 2020; 6: 6501-6509.

15. Abolfotouh S, Moore D. Use of simultaneous traction over a halo ring to achieve reduction of a type 2 odontoid fracture for anterior odontoid screw fixation. Int J Surg Case Rep. 2019; 64: 97-101.

16. Mohamed M, A Hewedy M. Anterior Trans-odontoid Screw Fixation in Odontoid Fractures. Egypt Spine J. 2017; 22 (1): 41-49.

17. Rao G, Apfelbaum RI. Odontoid screw fixation for fresh and remote fractures. Neurology India. 2005; 53 (4): 416-423.

18. Wang LN, Li T, Yang X, Wang L, Liu LM, Liu H, et al. Comparison of two temporary fixation techniques for the treatment of type II odontoid fracture. Acta Orthop Belg. 2018; 84 (1): 108-115.

19. Tang S. C-1 lateral mass screw. J Neurosurg Pediatr. 2010; 6 (5): 513-514.

20. Joaquim AF, Patel AA. Specific considerations in older patients. Neurosurg Focus. 2015; 38: 1-6.

21. Charles YP, Ntilikina Y, Blondel B, Fuentes S, Allia J, Bronsard N, et al. Mortality, complication, and fusion rates of patients with odontoid fracture: the impact of age and comorbidities in 204 cases. Arch Orthop Trauma Surg. 2019; 139 (1): 43-51.

22. Yang Z, Yuan ZZ, Ma JX, Ma XL. Conservative versus surgical treatment for type II odontoid fractures in the elderly: grading the evidence through a meta-analysis. Orthop Traumatol Surg Res. 2015; 101 (7): 839-844.

23. Baogui L, Juwen C. Fusion rates for odontoid fractures after treatment by anterior odontoid screw versus posterior C1-C2 arthrodesis?: a meta-analysis. Arch Orthop Trauma Surg. 2019; 139 (10): 1329-1337.

24. Konieczny MR, Gstrein A, Müller EJ. Treatment algorithm for dens fractures: non-halo immobilization, anterior screw fixation, or posterior transarticular C1-C2 fixation. J Bone Joint Surg Am. 2012; 94 (19): 1-6.