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Percutaneous Image-Guided Anterior Screw Fixation of the Odontoid Process

  • Technical Note
  • Non-Vascular Interventions
  • Published:
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Abstract

Purpose

To describe the technique of percutaneous image-guided anterior screw fixation of the odontoid process in five patients using hydrodissection of the jugulo-carotid and pre-vertebral spaces.

Methods and Materials

Between 03/2018 and 03/2020, five patients from two university hospitals underwent a percutaneous image-guided anterior screw fixation of the odontoid process for one pathological fracture, two impending fractures and two traumatic fractures of the dens. Technical success was defined as a satisfactory positioning of the screw in the odontoid. Detailed data with the number and type of needles required, the time to perform hydrodissection, the volume of fluid used, the time for bone access, the size and lengths of the screws used, technical success, complications, clinical outcomes and follow-up were retrospectively assessed.

Results

Technical success was achieved in 100% (5/5 cases), with a mean volume of hydrodissection of 218 ± 8.4 mL (range 210–230). Mean total procedure time was 112 ± 34 min (range 70–160). The lengths of the screws ranged from 30 mm to 55 mm. Additional cementoplasty was performed in the three malignant cases. VAS scores dropped on a 10-point scale from mean 5.8 ± 2.2 pre-procedure to 0.8 ± 0.4 after the procedure. No major complication occurred.

Conclusion

Percutaneous image-guided anterior screw fixation of the odontoid process using hydrodissection of the jugulo-carotid and pre-vertebral spaces is technically feasible and seems safe.

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Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Service d’Imagerie Interventionnelle, Hôpitaux Universitaires de Strasbourg, 1, place de l’hopital, 67000, Strasbourg, France

    Pierre-Alexis Autrusseau, Roberto Luigi Cazzato, Guillaume Koch, Afshin Gangi MD, PhD & Julien Garnon

  2. Service d’Imagerie Interventionnelle, Hospices Civils de Lyon, 3, quai des Célestins, 69002, Lyon, France

    Damien Heidelberg & Nicolas Stacoffe

  3. Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Windmill Road, Oxford, OX3 7LD, UK

    Danoob Dalili

  4. School of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK

    Danoob Dalili

Authors
  1. Pierre-Alexis Autrusseau
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  2. Damien Heidelberg
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  3. Nicolas Stacoffe
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  4. Danoob Dalili
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  5. Roberto Luigi Cazzato
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  6. Guillaume Koch
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  7. Afshin Gangi MD, PhD
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  8. Julien Garnon
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Corresponding author

Correspondence to Pierre-Alexis Autrusseau.

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Autrusseau, PA., Heidelberg, D., Stacoffe, N. et al. Percutaneous Image-Guided Anterior Screw Fixation of the Odontoid Process. Cardiovasc Intervent Radiol 44, 647–653 (2021). https://doi.org/10.1007/s00270-020-02734-9

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  • DOI: https://doi.org/10.1007/s00270-020-02734-9

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