A Comparative Study of Fixation Techniques for Type II Fractures of the Odontoid Process

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Abstract
Primary Screw fiction of a Type II odontoid fracture or non-union is an attractive alternative to posterior atlantoaxial arthrodesis in that normal cervical motion can be maintained. Eight cervical cadaver spines, ranging in age from 17–90 years, were used for study, Type II fractures of the dens were created using an ostectome. Simulated fractures were fixed using one or two 3.5-mm bone screws. After tasting each screw fixation technique, the screws were removed and a posterior C1–C2 brooks sublaminar wiring was performed using four 18-gauge wires with wooden blocks to simulate bone graft. No significant differences were found between bending and torsional stiffnesses for the one-screw and two-screw specimens. No significant differences ware found between one- and two-screw fixation when compared with primary C1–C2 wiring in torsion. One- or two-screw fixation was as stiff as primary C1–C2 wiring in bending. One or two screws offers similar stability for fixation for a dens fracture. One- and two-screw fixation is at least as stiff as primary C1–C2 wiring in torsion and one-or two-screw fixation is stiffer than primary C1–C2 wiring in bending.

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