Korean Journal of Neurotrauma  2012;8(2):87-93

doi:10.13004/kjnt.2012.8.2.87

Analysis of Risk Factors Associated with Fusion Failure of Traumatic Odontoid Fracture Type III after Halo-Vest Immobilization.

Dong Kwang SEO 1 ; Jin Hoon PARK ; Dong Ho LEE ; Sang Ryong JEON

Affiliations

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Keywords

Odontoid process; Spinal fractures; External fixators; Ununited fractures

Country

Republic of Korea

Language

Korean

Abstract

OBJECTIVE: The purpose of this study is to identify risk factors related to the fusion failure after halo-vest immobilization of odontoid fracture type III. METHODS: We retrospectively analyzed ten patients who underwent halo-vest immobilization for acute traumatic odontoid fracture between October 2002 and December 2011. All patients had type III odontoid fracture using the Anderson and D'Alonzo classification. We reviewed digital radiographs and analyzed the images during conservative treatment with halo-vest immobilization. RESULTS: The patients consisted of nine men and one woman, with mean age of 40.2 years (range: 25-56), who had no history of medical comorbidity and significant neurologic deficit. The mean follow-up period was 6 months (range: 4-11). All patients were initially treated by halo-vest immobilization. Seven patients showed union of fractured site on radiologic findings after halo-vest immobilization only. However, other 3 patients underwent surgery for fixation due to fusion failure. Among the factors we analyzed such as, radiographic characteristics and clinical feature, presence of comminuted fracture, instability of fractured fragment and failed reduction of misalignment were the factors related to fusion failure. CONCLUSION: The fusion rate of halo-vest immobilization of odontoid fracture type III seem to be incomplete, but clinical decision using the risk factors such as comminution, instability of fractured fragment and failed reduction of misalignment improves the outcome with conservative management.