ODONTOID FRACTURE TREATED WITH CEMENT-AUGMENTED DIRECT ANTERIOR SCREW OSTEOSYNTHESYS IN ELDERLY PATIENTS

Abstract

Purpose of the Study The authors retrospectively evaluate data of a cohort of patients operated on with the same surgical technique over a 10-year period with a mean age of 81.7 years for odontoid fracture. Material and Methods Between 2012 and 2021 we performed cement-augmented direct anterior screw osteosynthesis in. The mean follow-up period was 2.7 years. Results A total of 41 screws were inserted, 2 screws in 7 patients, Total of 33 patients (97%; N=34) odontoid type II fracture, 1x type III (1%; N = 34. We lost 5 patients from follow up. Radiologically we found 20x fusion (69%; N = 29), 7x pseudoarthrosis stable (type I and II) (24.1%; N = 29), 2x loosening, failure (type III and IV) (7%; N = 29). We assessed as stable condition 27 times (93%; N = 29). On the follow-ups with no major reported pain VAS 2 (6.9 to 2 postoperatively) (p < 0.05), 26 (90%; N = 29) of living patients return to original activities at 1 year postoperatively. Perioperatively, we experienced 16 times cement leakage (47%; N=34). Conclusions In our institution, now the method of first choice for type II odontoid fractures in geriatric patients. It has a reasonable operative risk, preserve rotations of the upper cervical spine and quality of life of these patients (satisfaction 90%) and achieve stability of fracture in 93% of patients.

Keywords

• odontoid fracture
• cement augmentation
• elderly patients