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Abstract
Objective: Anterior single screw fixation is one of the surgical options providing sufficient immediate stabilization of the spine and preserving normal C1-2 motion. In this study the indications, the surgical technique, and outcome of patients who underwent this procedure were reviewed. Methods: Twenty two consecutive patients (17 males and 5 females) who underwent anterior single screw fixation for recent Type II and shallow type III odontoid fractures were included in this study. Data including clinical examination, imaging studies and operative technique were used to analyze the results of this surgical technique. Results: The clinical and radiological results, in our series, were conclusive. Clinically 87% of patients ranged between 2excellent3 and 2good3 (according to Smiley- Webster scale) Radiological evidence of bone union achieved in 14 patients (64% of cases), stable fibrous union in 7 patients (32%), and nonunion in 1 patients (4% of cases). Complications related to surgical procedure and hardware failure were recorded in 2 patients (9% of cases). Conclusions: Direct anterior single screw fixation is an effective, simple, and safe method for treating type II odontoid fractures. It is associated with rapid patient mobilization, minimal postoperative pain, and shorter hospital stay. By this technique, the required anatomical and functional outcome can be obtained through immediate stability of the axis, preserves C1{u2013}2 rotatory motion, and achieved high union rate. With the experience gained and better patient selection higher bony healing rates are expected with Odontoid screw fixation