Treatment Of Odontoid Fractures With Anterior Screw Fixation Based Iso-C 3D Navigation System

Objective:We evaluate the clinical outcome of single and double anterior screw fixation in the treatment of typeâ…¡andâ…¢( Anderson and D'Alonzo classification ) odontoid fractures based Iso-C 3D navigation system, and approach the best operative treatment prescription.Methods:We reviewed the cases of 27 patients (17 males and 10 females ), with an average age of 37.3 years ( age ranged from 18 to 70 ) at the time of surgery, who had undergone anterior screw fixation surgical treatment of a odontoid fracture (typeâ…¡19 patients and typeâ…¢8 patients) based Iso-C 3D navigation system from June 2004 to October 2007. 20 patients underwent single anterior screw fixation and 7 patients underwent double anterior screw fixation . 3 views of the cervical vertebrae, including anteroposterio,lateral and openmouth odontoid cervical radiographs and CT to evaluate union of fracture at the time of postoperative and follow up. To quantify the clinical outcome, the patients were asked to grade their functional outcome according to the Smiley-Webster scale basised of the degree of neck pain and neck motion at the final follow up as excellent,good,fair,and poor.Results:All of patients followed up ranged from 9 to 24 months, with an average month of 16 months. However one or two screws fixation, the union rates of fractures were 100%, and there were no complications (there were no imprecise placement of screws or screw failures). In the 20 patients with single screw fixation, an excellent result was obtained in 14 patients (70%), good in 4 patients (20%), and a fair result in 2 patients (10%). In the 7 patients with two screw fixation, excellent results were obtained in 7 patients (100%).Conclusions:Anterior screw fixation based Iso-C 3D navigation system is an effective procedure for unstable typeâ…¡andâ…¢odontoid fractures. This technique is safe,precise,and minimally invasive.