In the study group, there was a negative correlation between the range of motion and the patients’ age, i.e., the older the patient the poorer his/her spinal mobility ( p < 0.001). Statistically significant correlation was observed in the case of extension ( p < 0.021) and axial rotation ( p < 0.007). In the study group, spine mobility correlated with the duration of hard collar usage following the operation, with a longer duration corresponding to poorer spine mobility at the end of the treatment. The spinal motion was assessed using multi-cervical unit, taking into account bending/extension, left and right lateral flexion, and left and right axial rotation. The control group consisted of 41 individuals with no clinical diagnosis of any cervical spine disorders. Following the operation all the patients had to wear a cervical collar to protect the osteosynthesis. The study involved 41 patients subjected to a procedure of direct osteosynthesis of the dens with lag screw. This study aims to (1) to assess active cervical range of motion following types II and III odontoid fracture, successfully treated with anterior odontoid screw fixation, and (2) to examine the relationship between the range of motion of the head and duration of collar usage, neck pain, quality of life, and patients’ age. However, there are no clinical studies confirming the motion sparing value of this technique. ![]() Surgeons must be prepared to perform both procedures to adequately treat these injuries.ĪOSF = anterior odontoid screw fixation PCIF = posterior cervical instrumented fusion anterior odontoid screw fixation approach odontoid fractures posterior cervical instrumented fusion treatment.It is believed that direct odontoid screw fixation preserves the physiological cervical range of motion following surgery. Although both anterior and posterior approaches are acceptable, many clinical and radiological factors should be taken into account when choosing the best surgical approach. ![]() However, this technique results in loss of atlantoaxial motion, requires prone positioning, and demands a longer operative duration than AOSF, factors that can be a challenge in patients with severe medical conditions. It is also used as a salvage procedure after failed AOSF. PCIF allows direct open reduction of displaced fragments and can reduce any atlantoaxial subluxation. PCIF has a higher rate of fusion and is indicated in patients with severe atlantoaxial misalignment and with poor bone quality. Additionally, older patients may have a higher rate of pseudarthrosis using this technique, as well as postoperative dysphagia. AOSF can preserve atlantoaxial motion, but requires a reduced odontoid, an intact transverse ligament, and a favorable fracture line to achieve adequate fracture compression. In this paper, the authors review the literature about specific patients and fracture characteristics that may guide treatment toward one technique over the other. ![]() Anterior odontoid screw fixation (AOSF) and posterior cervical instrumented fusion (PCIF) are both well-accepted techniques for surgical treatment but with unique indications and contraindications as well as varied reported outcomes. Surgical treatment is recommended for patients older than 50 years with Type II odontoid fractures, as well as in patients at a high risk for nonunion. Fractures at the dens base, classified by the Anderson and D'Alonzo system as Type II injuries, are the most common pattern of all odontoid fractures and are also the most common cervical injuries in patients older than 70 years of age. Odontoid fractures comprise as many as 20% of all cervical spine fractures.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |