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Full‐Endoscopic Anterior Odontoid Screw Fixation: A Novel Surgical Technique
Author(s) -
Kotheeranurak Vit,
Pholprajug Phattareeya,
Jitpakdee Khanathip,
Pruttikul Pritsanai,
Chitragran Roongrath,
Singhatanadgige Weerasak,
Limthongkul Worawat,
Yingsakmongkol Wicharn,
Kim JinSung
Publication year - 2022
Publication title -
orthopaedic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.666
H-Index - 23
eISSN - 1757-7861
pISSN - 1757-7853
DOI - 10.1111/os.13271
Subject(s) - medicine , surgery , fixation (population genetics) , neck pain , radiography , percutaneous , range of motion , visual analogue scale , population , alternative medicine , environmental health , pathology
Objective First, to propose a novel minimally invasive technique of full‐endoscopic anterior odontoid fixation (FEAOF) that aims to reduce the risk of retropharyngeal approach (both open and percutaneous techniques) to anterior odontoid screw fixation. Second, to describe steps of the procedure and, lastly, to report the initial outcomes in patients treated with this novel technique. Methods Four non‐consecutive patients who were diagnosed with a displaced odontoid fracture (Anderson‐D'Alonzo classification type II and Grauer subclassification type A or B) from 2019 to 2020 underwent surgical fixation by our novel technique for anterior odontoid screw fixation. A detailed technical approach of FEAOF for the surgical treatment of type II odontoid fractures was described, and the patients' outcomes based on postoperative radiographic results including computed tomography (CT), clinical outcome parameters including visual analogue scale (VAS) for neck pain both preoperatively and at postoperative follow‐up, and range of neck motion at the final follow‐up were reported. Results The mean age was 33.5 years (24–41), three patients were male. The mean operative time was 93.75 min, and the mean blood loss was 7.5 ml. An immediate post‐operative thin‐sliced CT showed that all patients achieved satisfactory reduction and proper screw position. No screw malposition or penetration was found. At a 6‐month follow‐up, a thin‐sliced CT demonstrated solid bony union in every case. The mean VAS for neck pain was reduced from 6.5 to 0.6 at the 6‐months follow‐up. At the final follow‐up, all patients showed improvement in ranges of motion without any complications; however, one patient was lost to follow‐up. Conclusions FEAOF is a feasible and effective option for treating type II odontoid fractures. The procedure is less invasive than other techniques and provides clear direct visualization of the involved structures.

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