A new tool in percutaneous anterior odontoid screw fixation
Abstract Background Percutaneous anterior odontoid screw fixation for odontoid fractures remains challenging due to the complex anatomy of the craniocervical junction. We designed a new guide instrument to help with the placement of guide wire, which have achieved satisfying surgical results. The ob...
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| Format: | Article |
| Language: | English |
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BMC
2021-01-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-020-03929-4 |
| _version_ | 1818722247108460544 |
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| author | Yan Wang Min Li Guanxing Cui Jing Li Zhiliang Guo Dahai Zhang Haijun Teng Haijiang Lu |
| author_facet | Yan Wang Min Li Guanxing Cui Jing Li Zhiliang Guo Dahai Zhang Haijun Teng Haijiang Lu |
| author_sort | Yan Wang |
| collection | DOAJ |
| description | Abstract Background Percutaneous anterior odontoid screw fixation for odontoid fractures remains challenging due to the complex anatomy of the craniocervical junction. We designed a new guide instrument to help with the placement of guide wire, which have achieved satisfying surgical results. The objective of this study is to evaluate the safety and efficacy of this new tool in percutaneous anterior odontoid screw fixation. Methods Twenty-nine patients with odontoid fracture were retrospectively evaluated. All patients underwent percutaneous anterior odontoid screw fixation with the traditional guide instrument (n = 13) or the new guide instrument we designed (n = 16). The following clinical outcomes were compared between the two groups: operation time, radiograph times, incision length, blood loss, postoperative hospitalization, postoperative complications, bony union, fixation failure, and reoperation. Radiographs or CT scans were performed at 3, 6 and 12 months after surgery. Results There were no significant differences in preoperative demographic data between the two groups. The operation time (56.62 ± 8.32 Vs 49.63 ± 7.47, P = 0.025) and radiograph times (26.54 ± 6.94 Vs 20.50 ± 5.02, P = 0.011) of the designed guide instrument group were significantly lower than those of the traditional guide instrument group. There were no significant differences in incision length (16.08 ± 3.07 Vs 15.69 ± 2.73, P = 0.720), blood loss (16.08 ± 4.96 Vs 17.88 ± 5.98, P = 0.393), postoperative hospitalization (7.15 ± 1.91 Vs 6.88 ± 2.36, P = 0.734), postoperative complications (7.7% Vs 12.5%, P = 1), and bony union (92.3% Vs 93.8%, P = 1) between the two groups. No fixation failure or reoperation occurred in either group. Conclusions The top of our designed guide instrument is a wedge-shaped tip with 30° inclination, which has a large contact area with the anterior surface of the cervical vertebra. According to our retrospective study, the guide instrument can reduce the operation time and radiograph times. It has potential clinical value, which needs further testing with a higher level of research design. |
| first_indexed | 2024-12-17T20:51:35Z |
| format | Article |
| id | doaj.art-9ee8f4b693284abd9f7444223c1aa515 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-17T20:51:35Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-9ee8f4b693284abd9f7444223c1aa5152022-12-21T21:33:01ZengBMCBMC Musculoskeletal Disorders1471-24742021-01-0122111010.1186/s12891-020-03929-4A new tool in percutaneous anterior odontoid screw fixationYan Wang0Min Li1Guanxing Cui2Jing Li3Zhiliang Guo4Dahai Zhang5Haijun Teng6Haijiang Lu7Department of Orthopedic Surgery, Weifang Traditional Chinese Medicine HospitalDepartment of Medical Affairs, The Second Naval Hospital of Southern Theater Command of PLADepartment of Orthopedic Surgery, Affiliated Hospital of Weifang Medical UniversityDepartment of Orthopedic Surgery, Weifang Traditional Chinese Medicine HospitalDepartment of Orthopedic Surgery, The 80th Army Hospital of PLADepartment of Orthopedic Surgery, The 80th Army Hospital of PLADepartment of Orthopedic Surgery, The 80th Army Hospital of PLADepartment of Orthopedic Surgery, The 80th Army Hospital of PLAAbstract Background Percutaneous anterior odontoid screw fixation for odontoid fractures remains challenging due to the complex anatomy of the craniocervical junction. We designed a new guide instrument to help with the placement of guide wire, which have achieved satisfying surgical results. The objective of this study is to evaluate the safety and efficacy of this new tool in percutaneous anterior odontoid screw fixation. Methods Twenty-nine patients with odontoid fracture were retrospectively evaluated. All patients underwent percutaneous anterior odontoid screw fixation with the traditional guide instrument (n = 13) or the new guide instrument we designed (n = 16). The following clinical outcomes were compared between the two groups: operation time, radiograph times, incision length, blood loss, postoperative hospitalization, postoperative complications, bony union, fixation failure, and reoperation. Radiographs or CT scans were performed at 3, 6 and 12 months after surgery. Results There were no significant differences in preoperative demographic data between the two groups. The operation time (56.62 ± 8.32 Vs 49.63 ± 7.47, P = 0.025) and radiograph times (26.54 ± 6.94 Vs 20.50 ± 5.02, P = 0.011) of the designed guide instrument group were significantly lower than those of the traditional guide instrument group. There were no significant differences in incision length (16.08 ± 3.07 Vs 15.69 ± 2.73, P = 0.720), blood loss (16.08 ± 4.96 Vs 17.88 ± 5.98, P = 0.393), postoperative hospitalization (7.15 ± 1.91 Vs 6.88 ± 2.36, P = 0.734), postoperative complications (7.7% Vs 12.5%, P = 1), and bony union (92.3% Vs 93.8%, P = 1) between the two groups. No fixation failure or reoperation occurred in either group. Conclusions The top of our designed guide instrument is a wedge-shaped tip with 30° inclination, which has a large contact area with the anterior surface of the cervical vertebra. According to our retrospective study, the guide instrument can reduce the operation time and radiograph times. It has potential clinical value, which needs further testing with a higher level of research design.https://doi.org/10.1186/s12891-020-03929-4Odontoid fractureAnteriorScrew fixationPercutaneousBony union |
| spellingShingle | Yan Wang Min Li Guanxing Cui Jing Li Zhiliang Guo Dahai Zhang Haijun Teng Haijiang Lu A new tool in percutaneous anterior odontoid screw fixation BMC Musculoskeletal Disorders Odontoid fracture Anterior Screw fixation Percutaneous Bony union |
| title | A new tool in percutaneous anterior odontoid screw fixation |
| title_full | A new tool in percutaneous anterior odontoid screw fixation |
| title_fullStr | A new tool in percutaneous anterior odontoid screw fixation |
| title_full_unstemmed | A new tool in percutaneous anterior odontoid screw fixation |
| title_short | A new tool in percutaneous anterior odontoid screw fixation |
| title_sort | new tool in percutaneous anterior odontoid screw fixation |
| topic | Odontoid fracture Anterior Screw fixation Percutaneous Bony union |
| url | https://doi.org/10.1186/s12891-020-03929-4 |
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