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Journal of Craniovertebral Junction and Spine
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Year : 2019  |  Volume : 10  |  Issue : 4  |  Page : 254-258

Stent augmentation of an anterior odontoid screw for type 2 odontoid fracture-dislocation in the elderly population: Report of two cases and literature review

1 Department of Spinal Surgery, Queen's Medical Center, Nottingham, UK
2 Spinal Center (Dr. Med Habil), Benedictus Hospital, Tutzing, Germany

Correspondence Address:
Mr. Saurabh Kapoor
15 Chester House, Radcliffe Road, Nottingham NG3 5AW
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcvjs.JCVJS_91_19

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The fixation of type 2 odontoid fractures poses significant challenges in the elderly population due to coexistent osteoporosis and communition resulting in a high failure rate with conventional anterior screw fixation. Two elderly patients with unstable odontoid peg fractures and coexistent osteoporosis were treated with stentoplasty and anterior odontoid screw fixation. Additional anterior transarticular C1–2 screws were placed to address C1–2 instability. Both patients made an uneventful clinical recovery. One of the anterior C1–2 screws loosened due to the poor purchase in the osteoporotic bone in one patient. This did not affect the final outcome, and both the patients demonstrated maintained reduction and good alignment of odontoid peg after 2 years of follow-up. There was no intraoperative cement leak, pseudoarthrosis, or loss of reduction. Stentoplasty coupled with the anterior odontoid screw is a safe technique that can provide a biomechanically sound fixation of type 2 odontoid fractures in the presence of osteoporosis and significant communition.

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