Surgical treatment of patients with fractures of C2 odontoid process in interim and delayed periods of trauma

Abstract

Objective: to optimize the surgical treatment strategy at patients with C2 odontoid process fractures in interim and delayed periods of trauma. Material and methods: We operated 12 patients (10 - men, 2 - women) with odontoid process fractures in interim and delayed periods of trauma from 03.05.2002 till 20.03.2011. The majority of patients (8 persons) were in active working age. According to Anderson and D’Alonzo classification (1974) 10 patients had type II of odontoid process fractures, 2 patients - type III. Results: Halo-immobilization for 1 month was performed on 37th day at one patient with type II of odontoid process fracture without dislocation. Halo-reposition with thoracocranial plaster bandage was performed at one female patient with type II of odontoid process fracture on 48th day after trauma. The posterior spondylodesis was done at 8 patients with Halo-correctable fractures, among them one patient required transoral decompression. The combined anterior-posterior surgical intervention was performed at 2 persons with Halo-noncorrectable fractures of odontoid persons. Conclusion: active surgical strategy at patients with fractures of odontoid process in interim and delayed period of trauma allows achieving the optimal clinical and orthopedic results.