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69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

03.06. - 06.06.2018, Münster

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Feasibility of cement-augmented anterior odontoid screw in geriatric patients with an odontoid fracture

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  • Falko Schwarz - Universitätsklinikum Jena, Klinik für Neurochirurgie, Jena, Deutschland
  • Jan Walter - Universitätsklinikum Jena, Klinik für Neurochirurgie, Jena, Deutschland
  • Rolf Kalff - Universitätsklinikum Jena, Klinik für Neurochirurgie, Jena, Deutschland
  • Albrecht Waschke - Universitätsklinikum Jena, Klinik für Neurochirurgie, Jena, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie. Münster, 03.-06.06.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. DocV268

doi: 10.3205/18dgnc286, urn:nbn:de:0183-18dgnc2866

Published: June 18, 2018

© 2018 Schwarz et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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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.