• DantasFernando Luiz RolembergFLRDepartment of Neurosurgery, Biocor Instituto/Rede D'Or, Minas Gerais, Brazil; Graduation in Health Sciences, Faculdade Ciências Médicas de Minas Gerais, Minas Gerais, Brazil. Electronic address: dantasfernando2@gmail.com., François Dantas, Gustavo Agra Cariri, CairesAntônio Carlos VieiraACVDepartment of Neurosurgery, Biocor Instituto/Rede D'Or, Minas Gerais, Brazil., Marco Túlio Domingos Silva E Reis, and Ricardo Vieira Botelho.
• Department of Neurosurgery, Biocor Instituto/Rede D'Or, Minas Gerais, Brazil; Graduation in Health Sciences, Faculdade Ciências Médicas de Minas Gerais, Minas Gerais, Brazil. Electronic address: dantasfernando2@gmail.com.
• World Neurosurg. 2023 Aug 1; 176: e535e542e535-e542.

ObjectiveType II odontoid fracture is the most common fracture type, and its treatment remains challenging. The objective of this study was to evaluate the results of anterior screw fixation for type II odontoid fractures in patients aged over and below 60 years.MethodsA retrospective analysis of consecutive patients diagnosed with type II odontoid fractures who were surgically treated using the anterior approach by a single surgeon was conducted. Demographic characteristics, including age, sex, type of fracture, time from trauma to surgery, length of stay (LoS), fusion rate, complications, and reoperation, were evaluated. Surgical outcomes were compared between patients over and below 60 years of age.ResultsSixty consecutive patients underwent odontoid anterior fixation during the analysis period. The mean age of patients was 49.58 ± 23.22 years. Twenty-three (38.3%) patients were aged over 60 years, and the minimum follow-up period was two years. Of the patients, 93.3% developed bone fusion, which was observed in 86.9% of patients over 60 years. Complications related to hardware failure occurred in six (10%) patients. Transient dysphagia was observed in 10% of the cases. Three (5%) patients required reoperation. Patients over 60 years had a significantly increased risk of dysphagia compared with those below 60 years (P = 0.0248). There was no significant difference between the groups regarding nonfusion rate, reoperation rate, or LoS.ConclusionsAnterior fixation of the odontoid showed high fusion rates with a low rate of complications. It is a technique to be considered for treating type II odontoid fractures in selected cases.Copyright © 2023 Elsevier Inc. All rights reserved.

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