Surgical treatment of dens fractures (also known as odontoid process/vertebra dentata) from frontal access

Introduction: Injuries of the cervical part of the spine may occur in many circumstances, but certain type of accidents and injuries are linked with spine injury/lesion and of the spinal cord. All dislocations within C1-C2 complex, both traumatic and in the process of many disorders, may be suspected of fracturing the dens, or of damaging the transverse ligament of the odontoid vertebra. The fracture of the dens is classified according to the process of fracture fissure. This division was presented in 1974 by Andersena and d’Alonzo and is binding up-to-date, despite its different modifications. Type II is a dangerous, non-stable fracture, difficult to heal. It Leeds surgical treatment regardless of the fact whether there was dislocation of factions or not. Material: 23 patients treated in the Ward of Neurosurgery WSS PCT in Gda�?�?sk in the period 2004- 2008 constitute the clinical material. In all patients, a stabilization of the odontoid vertebra was carried out from frontal access with the application of Boehler screws. Results: In 22 patients, a good bone adhesion was obtained, stated during subsequent control studies. In the neurological study, in comparison to the pre-surgical state, ailments relief was achieved: dizziness, balance disorders, pains in the occipital region with stiffness. In one patient suffering from osteoporosis, fracture of the dens occurred alongside screw loosening. Conclusions: The application of stabilisation of the fractured dens with the help of self-pressure screw is a treatment method minimalising the size of surgical access. This technique allows to obtain good bone adhesion without disturbing the range of spinal flexion and exclusion of additional motor unit.