Artikel
Feasibility of cement-augmented anterior odontoid screw in geriatric patients with an odontoid fracture
Suche in Medline nach
Autoren
Veröffentlicht: | 18. Juni 2018 |
---|
Gliederung
Text
Objective: Osteoporotic bone commonly leads to a screw loosening in patients with an anterior odontoid screw. To reduce the rate of loosening we augment the screw with bone cement. Aim of the study is to evaluate the intra- and perioperative complications of this method.
Methods: From January 2012 till November 2017 we have treated 24 geriatric patients (18 female, 6 male) with a cement-augmented odontoid screw. Data were prospective collected from medical charts regarding intraoperative complications, 30-days mortality, revision surgeries, surgery time, cement leakage and bone density using the Lakshmanan grading.
Results: Median age of the patients was 84 years (range: 73-94). The bone density was in 42 % (n = 10) severe (Lakshmanan Grad 4) and in 58 % (n = 14) moderate reduced. In 5 cases (20,8%) a prevertebral cement leakage in the Longus colli muscle and in 1 case (4,2%) in the C2/3 joint was prominent. In all cases the leakage was asymptomatic. Median surgery time was 65 minutes with a 30-days mortality of 0 %. In follow-up 1 patient showed a secondary screw loosening without the necessity of a revision surgery.
Conclusion: The cement augmentation of the odontoid screw is a feasible and safe procedure in patients with a reduced bone density.