A Surgical Experience of a Odontoid Type II Fracture by Transoral Approach and Internal Fixation with Screws and Mini-plate.

Han, Jung Hun; Cho, Yong Jun; Hwang, Jang Hoe; Park, Yong Kee; Ahn, Myung Soo

Original Article

Journal of Korean Neurosurgical Society 1993;22(4): 604-609.

Jung Hun Han, Yong Jun Cho, Jang Hoe Hwang, Yong Kee Park, Myung Soo Ahn

Department of Neurosurgery, College of Medicine, Hallym University, Chunchon, Korea.

ABSTRACT

With changing mechanisms of injury, heightened clinical awareness, and better diagnostic technology, odontoid fractures constitute 9~18% of cervical fractures in recent reports. The odontoid type II fracture is the most common axis fracture and it is also the most difficult to treat. Type II fractures with greater than 6mm dens dislocation have a higher incidence of nonunion with nonoperative therapy and should be offered early operative reduction with fusion. Recently we have experienced a young male patient with odontoid type II fracture. The degree of dens dislocation was 8mm. The fractured odontoid process was removed through transoral-transpharyngeal approach and bone fusion was performed with iliac bone. And the inserted bone was fixed with screws and mini-plate for further stabilization. The operative result was good without any serious complications. The operation technique is detailed.

Key Words: The odontoid type II fracture; Transoral approach; Internal fixation; Operation technique