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Computed tomographic evaluation of odontoid process: implications for anterior screw fixation of odontoid fractures in an adult population

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Abstract

Introduction

Odontoid diameter in some individuals may not be large enough to accommodate two 3.5-mm cortical screws for anterior odontoid fracture fixation. The study was performed to evaluate, in a Brazilian population, the diameter of the odontoid process and the feasibility of using two 3.5-mm cortical screws for anterior odontoid fracture fixation.

Materials and methods

Computed tomographic (CT) scans of 88 adult patients (aged 18–78 years) were analyzed; 40 patients (45%) were male (mean age: 43.08 years) and 48 (55%) were female (mean age: 43.39 years). The minimum external and internal anteroposterior and transverse diameters of the odontoid process on sagittal and coronal planes were measured on CT multiplanar reconstructions of the cervical spine.

Results

The mean value of the minimum external anteroposterior diameter was 10.83 ± 1.08 and 7.53 ± 1.10 mm for the minimum internal anteroposterior diameter. The mean value of the minimum external transverse diameter was 9.19 ± 0.91 and 6.07 ± 1.08 mm for the minimum internal transverse diameter. The mean AP diameter was significantly larger than the mean transverse diameter; 57 (65%) individuals had the minimum external transverse diameter >9.0 mm that would allow the insertion of two 3.5-mm cortical screws with tapping, and five (6%) individuals had the minimum internal transverse diameter >8.0 mm that would allow the insertion of two 3.5-mm cortical screws without tapping.

Conclusions

The insertion of two 3.5-mm cortical screws was possible for anterior fixation of odontoid fracture in 57 (65%) individuals of our study, and there was no statistical difference between males and females.

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Conflict of interest

None of the authors has any potential conflict of interest.

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Authors and Affiliations

  1. Spine Division, Department of Orthopaedics and Traumatology, Federal University of Goiás (UFG), Rua 109 nº 331 aptº 301 Setor Sul, Goiânia-Go, CEP 74085-090, Brazil

    Murilo Tavares Daher & Sérgio Daher

  2. Radiology Division, Department of Internal Medicine, Ribeirao Preto School of Medicine, University of São Paulo (USP), Ribeirão Preto, Brazil

    Marcello Henrique Nogueira-Barbosa

  3. Department of Biomechanics, Medicine and Rehabilitation of the Locomotor System of Ribeirão Preto School of Medicine, University of São Paulo (USP), Ribeirão Preto, SP, Brazil

    Helton Luíz Aparecido Defino

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  1. Murilo Tavares Daher
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  2. Sérgio Daher
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  3. Marcello Henrique Nogueira-Barbosa
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  4. Helton Luíz Aparecido Defino
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Correspondence to Murilo Tavares Daher.

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Daher, M.T., Daher, S., Nogueira-Barbosa, M.H. et al. Computed tomographic evaluation of odontoid process: implications for anterior screw fixation of odontoid fractures in an adult population. Eur Spine J 20, 1908–1914 (2011). https://doi.org/10.1007/s00586-011-1879-2

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  • DOI: https://doi.org/10.1007/s00586-011-1879-2

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