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Odontoid Screw
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Pre-Procedure

      • Procedure

        TERMINOLOGY

        • Synonyms

          • Primary osteosynthesis of dens
          • Anterior odontoid screw fixation
        • Definitions

          • Used for treatment of type II odontoid fractures
            • Fracture through base of odontoid where blood supply and quality of bone diminished
            • Fall or motor vehicle collision
            • Patients are typically neurologically intact
            • Nonunion rate with conservative management variable, ranges from 30-85%

        PRE-PROCEDURE

        • Indications

          • Contraindications

            PROCEDURE

            • Procedure Steps

              • Alternative Procedures/Therapies

                OUTCOMES

                • Problems

                  • Complications

                    Selected References

                    1. Denaro V et al: The best surgical treatment for type II fractures of the dens is still controversial. Clin Orthop Relat Res. 469(3):742-50, 2011
                    2. Pal D et al: Type II odontoid fractures in the elderly: an evidence-based narrative review of management. Eur Spine J. 20(2):195-204, 2011
                    3. Aebi M: Surgical treatment of upper, middle and lower cervical injuries and non-unions by anterior procedures. Eur Spine J. 19 Suppl 1:S33-9, 2010
                    4. Harrop JS et al: Optimal treatment for odontoid fractures in the elderly. Spine (Phila Pa 1976). 35(21 Suppl):S219-27, 2010
                    5. Lall R et al: A review of complications associated with craniocervical fusion surgery. Neurosurgery. 67(5):1396-402; discussion 1402-3, 2010
                    6. Koller H et al: C2-fractures: part II. A morphometrical analysis of computerized atlantoaxial motion, anatomical alignment and related clinical outcomes. Eur Spine J. 18(8):1135-53, 2009
                    7. Shears E et al: Surgical versus conservative management for odontoid fractures. Cochrane Database Syst Rev. (4):CD005078, 2008
                    8. Daentzer D et al: Vertebral artery complications in anterior approaches to the cervical spine: report of two cases and review of literature. Surg Neurol. 59(4):300-9; discussion 309, 2003
                    9. Ziai WC et al: A six year review of odontoid fractures: the emerging role of surgical intervention. Can J Neurol Sci. 27(4):297-301, 2000
                    10. Subach BR et al: Management of acute odontoid fractures with single-screw anterior fixation. Neurosurgery. 45(4):812-9; discussion 819-20, 1999
                    11. Marchesi DG: Management of odontoid fractures. Orthopedics. 20(10):911-6, 1997
                    12. Traynelis VC: Evidence-based management of type II odontoid fractures. Clin Neurosurg. 44:41-9, 1997
                    13. Chiba K et al: Treatment protocol for fractures of the odontoid process. J Spinal Disord. 9(4):267-76, 1996
                    Related Anatomy
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                    Related Differential Diagnoses
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                    References
                    Tables

                    Tables

                    KEY FACTS

                    • Terminology

                      • Pre-Procedure

                        • Procedure

                          TERMINOLOGY

                          • Synonyms

                            • Primary osteosynthesis of dens
                            • Anterior odontoid screw fixation
                          • Definitions

                            • Used for treatment of type II odontoid fractures
                              • Fracture through base of odontoid where blood supply and quality of bone diminished
                              • Fall or motor vehicle collision
                              • Patients are typically neurologically intact
                              • Nonunion rate with conservative management variable, ranges from 30-85%

                          PRE-PROCEDURE

                          • Indications

                            • Contraindications

                              PROCEDURE

                              • Procedure Steps

                                • Alternative Procedures/Therapies

                                  OUTCOMES

                                  • Problems

                                    • Complications

                                      Selected References

                                      1. Denaro V et al: The best surgical treatment for type II fractures of the dens is still controversial. Clin Orthop Relat Res. 469(3):742-50, 2011
                                      2. Pal D et al: Type II odontoid fractures in the elderly: an evidence-based narrative review of management. Eur Spine J. 20(2):195-204, 2011
                                      3. Aebi M: Surgical treatment of upper, middle and lower cervical injuries and non-unions by anterior procedures. Eur Spine J. 19 Suppl 1:S33-9, 2010
                                      4. Harrop JS et al: Optimal treatment for odontoid fractures in the elderly. Spine (Phila Pa 1976). 35(21 Suppl):S219-27, 2010
                                      5. Lall R et al: A review of complications associated with craniocervical fusion surgery. Neurosurgery. 67(5):1396-402; discussion 1402-3, 2010
                                      6. Koller H et al: C2-fractures: part II. A morphometrical analysis of computerized atlantoaxial motion, anatomical alignment and related clinical outcomes. Eur Spine J. 18(8):1135-53, 2009
                                      7. Shears E et al: Surgical versus conservative management for odontoid fractures. Cochrane Database Syst Rev. (4):CD005078, 2008
                                      8. Daentzer D et al: Vertebral artery complications in anterior approaches to the cervical spine: report of two cases and review of literature. Surg Neurol. 59(4):300-9; discussion 309, 2003
                                      9. Ziai WC et al: A six year review of odontoid fractures: the emerging role of surgical intervention. Can J Neurol Sci. 27(4):297-301, 2000
                                      10. Subach BR et al: Management of acute odontoid fractures with single-screw anterior fixation. Neurosurgery. 45(4):812-9; discussion 819-20, 1999
                                      11. Marchesi DG: Management of odontoid fractures. Orthopedics. 20(10):911-6, 1997
                                      12. Traynelis VC: Evidence-based management of type II odontoid fractures. Clin Neurosurg. 44:41-9, 1997
                                      13. Chiba K et al: Treatment protocol for fractures of the odontoid process. J Spinal Disord. 9(4):267-76, 1996