Short-term posterior C1-C2 pedicle screw fixation without fusion to treat type II odontoid fracture among people under 60 years.
Arch Orthop Trauma Surg
; 142(4): 543-551, 2022 Apr.
Article
em En
| MEDLINE
| ID: mdl-33125545
ABSTRACT
INTRODUCTION:
Posterior C1-C2 pedicle screw fixation is a reliable technique used in treatment of type II odontoid fracture. However, the loss of cervical range of rotation motion (RORM) was inevitable. There were few studies focusing on the influence of short-term C1-C2 fixation with nonfusion technique to preserve cervical function in patients younger than 60 years. The purpose of this study was to compare cervical RORM which was measured by an improved goniometer, and the clinical outcomes between short-term and long-term C1-C2 fixation techniques in the treatment of Grauer type 2B and 2C odontoid fracture. MATERIALS ANDMETHODS:
This study represents a retrospective analysis, including patients who underwent primary C1-C2 fixation surgery. These patients were divided into short-term and long-term groups based on whether underwent a fixation removal operation. The clinical results were collected and compared between the two groups. Independent T test and Chi-square analyses were used to identify significant differences between the two groups and dependent T test was used within each group. Statistical significance was set at p < .05.RESULTS:
There were no severe postoperative complications, and all 60 patients achieved spinal stabilization after primary surgery. The mean rotation angle in the short-term group at last follow-up time was 138.39 ± 21.06°, which was better than 83.59 ± 13.06° in the long-term group (p < .05). The same statistical difference was observed in flexion-extension angle, which was 71.11 ± 18.73° in short-term group and 53.34 ± 18.23° in long-term group. The mean NDI score in short-term group at last follow-up time was 1.23 ± 0.86 and better than 8.24 ± 3.17 in long-term group. However, the VAS score in short-term group was 1.82 ± 0.54 which was worse compared to 0.64 ± 0.29 in long-term group.CONCLUSIONS:
The results demonstrated that primary C1-C2 fixation with nonfusion technique could support satisfactory clinical effects. In addition, the removal of instruments after bony fusion could improve the function of cervical movement significantly in patients under 60 years.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Fusão Vertebral
/
Fraturas da Coluna Vertebral
/
Parafusos Pediculares
/
Processo Odontoide
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Humans
Idioma:
En
Revista:
Arch Orthop Trauma Surg
Ano de publicação:
2022
Tipo de documento:
Article