Anterior screw fixation for odontoid fractures

The results of anterior screw fixation of odontoid fractures in 28 patients are presented. There were 27 type II- and 1 type III-injuries. Non-union w ith persistent instability had to be notified in one patient (3.6 %), secon dary posterior C1/2 fusion had to be performed. Incorrect positioning of th e screws in the odontoid with penetration of the posterolateral cortex occu rred in 3 patients (10.7 %). Malpositioning of the odontoid after screw fix ation was documented in 5 cases (17.9 %). Cardiopulmonary complications had to be treated in 5 patients (17.9 %), 4 patients (14.3 %) died in the post operative period. 17 patients could be followed up. Only 3 patients (17.8 % ) were free of symptoms. A significant limitation in ROM of axial relation was seen in 44 % of the patients. With anterior screw fixation of the odont oid high fusion rates can be achieved, however the procedure is technically demanding. Regarding the functional outcome, there is no significant diffe rence to other established treatment methods.