![]() Here we are highlighting the technical details of management of Type II odontoid fracture for which anterior screw fixation was done.Ī 19-year-old boy presented with complaints of severe neck pain and difficulty in neck movements following a road traffic accident. Hence the operating surgeon requires high expertise and skill to prevent damage to the vital structures along with a good theater set up. During entire surgical procedure simultaneous AP and lateral imaging is required. The surgical approach for anterior screw fixation involves dissection of prevertebral space and blind passage of screw, during which there is high chance of iatrogenic injury to the vital structures like carotid artery, trachea and esophagus. The main advantage with this method is preservation of rotatory movements of cervical spine. The anterior odontoid screw fixation provides good anatomical and functional results with 90% expected union rates. Posterior C1-C2 fusion will lead to loss of rotatory movement of cervical spine. Non-operative treatment of these fractures has high complication rates such as non-union, pseudoarthrosis along with pin tract infection, loosening of pins and other clinical complications associated to halo devices. Fractures involving the base of odontoid process is the most common and is classified as type II using the Anderson D’Alonso classification system. Odontoid process fractures account for 10%-15% of all cervical fractures.
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