![]() Ochoa G (2005) Surgical management of odontoid fractures. J Bone Jt Surg Br Vol 73(6):972–976Įlsaghir H, Böhm H (2000) Anderson type II fracture of the odontoid process: results of anterior screw fixation. Grob D, Jeanneret B, Aebi M, Markwalder TM (1991) Atlanto-axial fusion with transarticular screw fixation. Ni B, Guo Q, Lu X, Xie N, Wang L, Guo X, Chen F (2015) Posterior reduction and temporary fixation for odontoid fracture-a salvage maneuver to anterior screw fixation. Smith HE, Vaccaro AR, Maltenfort M, Albert TJ, Hilibrand AS, Anderson DG, Harrop J, Fehlings MG, Kopjar B, Brodke DS (2008) Trends in surgical management for type II odontoid fracture: 20 years of experience at a regional spinal cord injury center. Hou Y, Yuan W, Wang X (2011) Clinical evaluation of anterior screw fixation for elderly patients with type II odontoid fractures. Lee SH, Sung JK (2006) Anterior odontoid fixation using a 4.5-mm Herbert screw: the first report of 20 consecutive cases with odontoid fracture. Graziano G, Jaggers C, Lee M, Lynch W (1993) A comparative study of fixation techniques for type II fractures of the odontoid process. Song KJ, Lee KB, Kim KN (2007) Treatment of odontoid fractures with single anterior screw fixation. J Bone Jt Surg Am Vol 61(8):1119–1142Ĭlark CR (1985) Fractures of the dens. An analysis of three hundred hospitalized patients and review of the literature. ![]() Spine 31(11 Suppl):S53īohlman HH (1979) Acute fractures and dislocations of the cervical spine. Maak TG, Grauer JN (2006) The contemporary treatment of odontoid injuries. However, the conclusion should be verified by further study enrolling larger sample size.Ĭhutkan NB, King AG, Harris MB (1997) Odontoid fractures: evaluation and management. ![]() Overall, there is no significant discrepancy between these two surgical approaches. ConclusionĮlderly patients (≥ 60 years) underwent posterior C1–2 arthrodesis fixation shows higher fusion rates in developed countries comparing with patients who underwent anterior odontoid screw fixation. However, it is shown that better fusion rates of patients (≥ 60 years) in developed countries received a better fusion rates after posterior fixation compared with anterior group using the fixed-effect model (RR = 0.88, 95% CI 0.79–0.98). As to age- and economic-level subgroups, there was no statistical evidence to suggest an association of the patient age and economy development level with the choice of surgical approach. There was no significant heterogeneity among the studies ( p value = 0.60). Results show that no significant difference was found in the overall fusion rate (RR = 0.96, 95% CI 0.90–1.01). Thirteen studies were enrolled in the meta-analysis. Risk ratio (RR) with its 95% confidence interval (CI) was pooled to assess fusion rates after surgical treatments, including anterior odontoid screw fixation approach or posterior C1–2 arthrodesis procedure, for patients with odontoid fractures. MethodsĪ computerized search of Ovid, Medline, Embase, and the Cochrane library up to December 2017 for literature on the complication rate during odontoid fracture treatment was conducted. Therefore, this study was aimed to investigate the discrepancy in fusion rate between these two surgical approaches through synthesizing the currently available evidence on the topic. In addition to surgical technique, the fusion rate is an important factor contributing to the clinical efficacy. However, the choice of different surgical procedures remains controversial. For odontoid fractures, surgical treatment approaches including anterior odontoid screw fixation approach and the posterior C1–C2 arthrodesis approach are generally adopted in practice.
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