Computed tomographic evaluation of odontoid process: implications for anterior screw fixation of odontoid fractures in an adult population

[摘要] IntroductionOdontoid diameter in some individuals may not be large enough to accommodate two 3.5-mm cortical screws for anterior odontoid fracture fixation. The study was performed to evaluate, in a Brazilian population, the diameter of the odontoid process and the feasibility of using two 3.5-mm cortical screws for anterior odontoid fracture fixation.Materials and methodsComputed tomographic (CT) scans of 88 adult patients (aged 18–78 years) were analyzed; 40 patients (45%) were male (mean age: 43.08 years) and 48 (55%) were female (mean age: 43.39 years). The minimum external and internal anteroposterior and transverse diameters of the odontoid process on sagittal and coronal planes were measured on CT multiplanar reconstructions of the cervical spine.ResultsThe mean value of the minimum external anteroposterior diameter was 10.83 ± 1.08 and 7.53 ± 1.10 mm for the minimum internal anteroposterior diameter. The mean value of the minimum external transverse diameter was 9.19 ± 0.91 and 6.07 ± 1.08 mm for the minimum internal transverse diameter. The mean AP diameter was significantly larger than the mean transverse diameter; 57 (65%) individuals had the minimum external transverse diameter >9.0 mm that would allow the insertion of two 3.5-mm cortical screws with tapping, and five (6%) individuals had the minimum internal transverse diameter >8.0 mm that would allow the insertion of two 3.5-mm cortical screws without tapping.ConclusionsThe insertion of two 3.5-mm cortical screws was possible for anterior fixation of odontoid fracture in 57 (65%) individuals of our study, and there was no statistical difference between males and females...

[学科分类] 骨科学

[关键词] Odontoid process ;Dens ;Quantitative computed tomography ;Spiral computed ;Fracture fixation ;Internal ;Orthopedic fixation devices