Results of long-term follow-up in patients undergoing anterior screw fixation for type II and rostral type III odontoid fractures

Kostas N. Fountas, Eftychia Z. Kapsalaki, Ioannis Karampelas, Carlos H. Feltes, Vassilios G. Dimopoulos, Theofilos G. Machinis, Leonidas G. Nikolakakos, Angel N. Boev, Haroon Choudhri, Hugh F. Smisson, Joe S. Robinson

Research output: Contribution to journalArticlepeer-review

82 Scopus citations


Study Design. Retrospective analysis of the fusion rate of a group of 38 patients having undergone anterior screw fixation for type II and "shallow" type III odontoid fractures. Objective. To determine primarily the long-term fusion rate after anterior screw fixation and to study the clinical characteristics of patients that have a statistically significant or nonsignificant influence on successful outcome. Summary of Background Data. Long-term outcome of anterior screw fixation for odontoid fractures has been evaluated in very few studies. This information should be critical for further establishing this technique as a major therapeutic strategy for these cases. Methods. Thirty-eight patients, 25 males and 13 females (with mean age 48.4 ± 0.4 years), with type II and rostral type III odontoid fractures, underwent anterior cannulated screw fixation during a 62-month period. Radiologic examination of the cervical spine with plain radiographs was performed at 6 weeks, and 2, 6,12, and 24 months, while computerized tomography of the upper cervical spine (C1-C3) was obtained at 6 months after surgery. Follow-up was available for 31 patients, and the follow-up time ranged from 39 to 87 months (mean 58.4). Results. Radiographic evaluation of the follow-up group showed satisfactory bony fusion and no evidence of abnormal movement at the fracture site in 27 (87.1%) patients. Pseudarthrosis developed in 4 (12.9%) patients; however, 3 (9.6%) of them without instability and 1 (3.2%) with instability. One (3.2%) patient had an instrumentation failure without instability. Conclusions. In our series, anterior odontoid screw fixation comprised a safe therapeutic modality with high stability and low mechanical failure rates during short-term and long-term follow-up.

Original languageEnglish (US)
Pages (from-to)661-669
Number of pages9
Issue number6
StatePublished - Mar 1 2005


  • Anterior
  • Fusion
  • Instrumentation failure
  • Odontoid fracture
  • Screw fixation
  • Surgical outcome

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Clinical Neurology


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