Functional and goniometric outcomes after surgical treatment of odontoid fractures

Abstract

Background: Surgical approaches to stabilize Type-II odontoid fractures include posterior atlantoaxial fixation (PAF) and anterior screw fixation (ASF). While ASF may theoretically allow for greater preservation of neck motion compared to PAF, there is a lack of evidence that one method preserves rotation and function better than the other. Methods: Single-centre study involving patients under 75 years old who underwent surgery for Type-II odontoid fracture. Following chart review, degree of neck rotation was assessed in patients using goniometric measurements. Participants completed questionnaires to investigate their perception of neck function and overall health (Neck Disability Index, Short Form-12, and EuroQol 5-D). Results: Patient recruitment is ongoing. To date, eleven patients have been reviewed (7 PAF, 4 ASF). Mean patient age was 61+/−12 years in the PAF group and 52+/−16 years in the ASF group. Measured neck rotation was lower in the PAF group compared to the ASF group (mean 58 vs. 110.5 degrees). However, the PAF group also reported fewer functional complaints. Conclusions: Preliminary data suggest that patients who receive ASF tend to be younger. While range of neck rotation is superior in ASF patients, their perception of functional ability does not correlate, suggesting that perceived neck function is multifactorial.