A modified posterior C1/C2 fusion technique for the management of traumatic odontoid type II fractures by using intraoperative spinal navigation: midterm results

Objectives: To assess midterm safety and efficacy of a modified Goel-Harms technique for the treatment of odontoid instabilities. - Design: Longitudinal prospective cohort study. - Setting: Urban Level 1 Trauma Center in Southwest Germany. - Patients/Participants: Orthopaedic...

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Hauptverfasser: Ishak, Basem (VerfasserIn) , Schneider, Till M. (VerfasserIn) , Gimmy, Valerie (VerfasserIn) , Unterberg, Andreas (VerfasserIn) , Kiening, Karl (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: September 2018
In: Journal of orthopaedic trauma
Year: 2018, Jahrgang: 32, Heft: 9, Pages: 366-371
ISSN:1531-2291
DOI:10.1097/BOT.0000000000001241
Online-Zugang:Verlag, Volltext: https://doi.org/10.1097/BOT.0000000000001241
Verlag, Volltext: https://journals.lww.com/jorthotrauma/fulltext/2018/09000/A_Modified_Posterior_C1_C2_Fusion_Technique_for.15.aspx
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Verfasserangaben:Basem Ishak, Till Schneider, Valerie Gimmy, Andreas W. Unterberg, Karl L. Kiening

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520 |a Objectives: To assess midterm safety and efficacy of a modified Goel-Harms technique for the treatment of odontoid instabilities. - Design: Longitudinal prospective cohort study. - Setting: Urban Level 1 Trauma Center in Southwest Germany. - Patients/Participants: Orthopaedic and neurosurgical trauma patients older than 18 years admitted for ≤24 hours. - Main Outcome Measurements: The outcome was evaluated with respect to neurological outcome, radiological outcome and surgical complications. For the functional assessment, the EQ-5D questionnaire was used. Furthermore, the Neck Disability Index and visual analog scale for neck pain were determined. A median follow-up of 39 months (range: 6-97 months) was given. - Results: Of the total sample (n = 56), 26 patients with an acute traumatic odontoid fracture type II underwent posterior atlantoaxial instrumentation using spinal navigation. Neck pain evaluated with visual analog scale and Neck Disability Index showed a significant decrease at final follow-up compared to preoperative values (P < 0.05). According to the EQ-5D, the valuation of quality of life after C1/C2 fusion showed an excellent outcome with complete recovery in most cases (0.7-1). - Conclusions: Our results demonstrate satisfactory and maintained midterm clinical and radiological results after a median follow-up of 39 months. With the use of intraoperative spinal navigation, we demonstrate a modified C1/C2 posterior fusion technique, rendering accuracy, feasibility, and overall safety. - Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. 
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