Türk Nöroşirürji Dergisi 2015 , Vol 25 , Num 2
Anterior Approaches to the Craniovertebral Junction
Nuri Eralp ÇETİNALP1, Kerem Mazhar ÖZSOY1, Yurdal GEZERCAN2, Tahsin ERMAN1
1Çukurova Üniversitesi, Tıp Fakültesi, Nöroşirürji Anabilim Dalı, Adana, Türkiye
2Adana Numune Eğitim ve Araştırma Hastanesi, Nöroşirürji Kliniği, Adana, Türkiye
Odontoid fractures comprise as many as 20% of all cervical spine fractures with the peak incidence in young adulthood and the elderly. Anderson and D’Alonzo have classified odontoid fractures into 3 types. Fractures at the base of the dens, being the most common type, are classified as type 2 injuries. Treatment strategies include external immobilization and surgical stabilization using anterior or posterior approaches. In any case, maintaining functional ability and stability, decreasing neurologic deficits and prevention of further disability must be the goals of the treatment. Anterior screw fixation of type 2 odontoid fractures provides immediate stabilization while preserving C1-2 motion. Preservation of the posterior muscles and tension band also ensures less postoperative pain and more stability. Although this technique provides good fusion rates, it can be technically challenging. In this context, proper patient selection, and identification of the screw entry point and trajectory under fluoroscopic guidance are the crucial elements for a good clinical outcome. Anahtar Kelimeler : Cervical spine, Odontoid fracture, Anterior odontoid screw fixation