The posterior pedicle screw fixation in the treatment of odontoid fracture

Objective To evaluate the application and effect of the posterior pedicle screw fixation in the treatment of odontoid fracture.Methods From August 2007 to February 2011,18 cases with odontoid fracture were selected and given atlas pedicle screws nail technology as well as the hub for vertebral pedicle screws nail technology for treatment.Results All patients were followed up for 8-24 months,with an average of 16 months.After the X-ray and CT scan verified,all cases had a solid bony union and the transpedicularscrews were in the proper position;and there was no loosening or breaking situation happened.One screw was inserted so medially as to penetrate into spinal canal.Another screw was perforated into the lateral wall of the vertebral pedicle.But other screw were in the proper position;and there were no injuries of spinal cord and vertebral artery.Vertebral venous damage happened in another 3 cases,but without clinical consequences.4 patients were fully recovered,and another one was with incomplete reduction.The wound-healing was going smoothly and well.5 patients recovered from Frankel grade D to Frankel grade E.13 cases remained with the Frankel grade E.Patients were cervico-occipital pain free and got slightly restricted with the rotational function.Conclusion The Posterior pedicle screw fixation has advantages of short-segment fixation,direct screw placement,intraoperative reduction and high fusion rate.It has little influence on cervical function,greatly improves atlantoaxial stability and promotes functional recovery of spinal cord.The transpedicular fixation is an effective method for the treatment of odontoid fracture.