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Short-term posterior C1–C2 pedicle screw fixation without fusion to treat type II odontoid fracture among people under 60 years

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

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 and methods

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.

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Data availability

All data are fully available without restriction.

Abbreviations

ACSF:

Anterior cannulated screws fixation

RORM:

Range of rotation motion

NDI:

Neck disability index

VAS:

Visual analog scale

CT:

Computer tomography

MRI:

Magnetic resonance imaging

AAD:

Atlantoaxial dislocation

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Acknowledgements

There is no conflict of interest among all the authors.

Funding

This work was supported by Grants from Capital Characteristic Clinical project of Beijing Municipal Science and Technology Commission (https://www.bjkw.gov.cn/n8785584/index.html) (Grant no. Z161100000516009). No individuals employed or contracted by the funders played any role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author information

Authors and Affiliations

  1. Graduate School of Peking Union Medical College, Beijing, 100029, People’s Republic of China

    Jipeng Song, Long Gong & Mingsheng Tan

  2. Orthopedics Department, China-Japan Friendship Hospital, Beijing, People’s Republic of China

    Jipeng Song, Ping Yi, Yanlei Wang, Long Gong, Yan Sun, Feng Yang, Xiangsheng Tang & Mingsheng Tan

  3. Graduate School of Beijing University of Chinese Medicine, Beijing, People’s Republic of China

    Yanlei Wang & Yan Sun

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  1. Jipeng Song
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Contributions

MsT and PY conceived and designed the study. YS, LG, and XsT collected the data. JpS analyzed the data. JpS and YlW wrote the paper. FY and XsT reviewed and edited the manuscript. All the authors read and approved the manuscript.

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Correspondence to Mingsheng Tan.

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Conflict of interest

There were no competing interests existing among all the authors and institutions in our study.

Ethics approval and consent to participate

The study was approved by the Ethics Committee of China–Japan Friendship Hospital (belongs to National Health Commission of the People’s Republic of China) and was waived patients consent because of the nature of retrospective study.

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We have obtained consent to publish to report individual patient data (images).

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Song, J., Yi, P., Wang, Y. et al. 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, 543–551 (2022). https://doi.org/10.1007/s00402-020-03641-x

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