Clinical and radiological outcomes of patients on whom posterior C1-C2 stabilization is applied in C2 odontoid fractures

Abstract

C2 odontoid fractures constituting 18% of total cervical fractures have a high mortality rate. These fractures may be treated with surgical methods such as external immobilization and odontoid screwing, and anterior or posterior transarticular screwing. Our study presents the clinical and radiological outcomes of patients who received C1-C2 posterior stabilization in C2 odontoid fractures. Twenty patients who underwent posterior C1-2 stabilization at İnönü University neurosurgery clinic between 01.01.2015 and 01.06.2020 were included in this study. These patients were categorized based on their age, sex, fusion ratio, failure to position the fracture line, comorbid diseases, additional trauma, type of accident, duration of hospitalization, the shape of the fracture line, complications and calcification ratios around the dens, and they were followed up for six months. There was a fusion in the fracture line of 19 (95.0%) patients. It is possible to fail to position the fracture in those with irregular fracture lines among patients, and there was a statistically significant difference regarding this issue (p=0.001). There were 3 (15.0%) patients with calcification around the dens. There was a significant relationship between calcification around the dens and age, where the calcification ratio increased as the age increased (p=0.004). The fusion rate is high among patients who receive C1-C2 stabilization. In patients where calcification develops around the dens, the possibility of neck pain to continue despite the stabilization removal should be kept in mind. In the treatment of C2 odontoid fractures,posterior C1-2 stabilization is an effective method.