• Q Dean, S Jiefu, W Jie, and S Yunxing.
• Department of Orthopedics, The Provincial People's Hospital of Shanxi, Taiyuan, Shanxi 30012, China. qindean.student@sina.com
• Spinal Cord. 2010 Feb 1;48(2):174-7.

Study DesignA case report to describe the minimally invasive technique of treating C1-type II odontoid combination fractures.ObjectiveTo introduce a new, minimally invasive technique of triple anterior screw fixation for acute combination atlas-axis fractures.Summary Of Background DataManagement for C1-type II odontoid combination fractures includes traction, immobilization and posterior fusion with and without instrumentation and anterior odontoid screw fixation. The combination of odontoid and bilateral transarticular C1-C2 anterior screw fixation is a recent addition in treating C1-type II odontoid fractures.MethodsA case of combination atlas-type II odontoid fracture occurred in a 39-year-old man. Imaging examinations showed a fracture of the unilateral anterior and posterior arch of C1 associated with type II odontoid fracture and with significant prevertebral soft tissue edema. Treatment consisted of odontoid and bilateral C1-C2 transarticular screw fixation through bilateral anterior small incisions.ResultsThe patient was mobilized early postoperatively with a hard cervical collar and discharged 4 days later. On 2-year follow-up, he presented no cervical complaints and only mild reduction in neck rotation.ConclusionIn case of C1-type II odontoid fracture, the triple anterior screw fixation can be taken into consideration as an alternative because of its superiority of minimal invasion, stability and safety.

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