ABSTRACT
I INTRODUCTION The rationale for direct anterior fixation of odontoid fractures is to improve the chance of healing in an anatomically reduced position while avoiding restrictive bracing and the complications associated with bone grafting techniques. By providing stable internal fixation, these goals may be met while preserving motion at the C1C2 articulation. It is rare that spine surgeons are able to perform direct fixation of a spinal fracture to allow primary healing, rather than fuse a motion segment across an injury. Direct anterior osteosynthesis of the odontoid fracture with anterior odontoid screw fixation is an alternative to atlantoaxial arthrodesis for management of odontoid fractures that are at risk for nonunion which avoids halo immobilization. Although the success rate of posterior C1-C2 fusion is very high for these fractures, this ‘‘success’’ results in significant loss (50%) of axial rotation (1). Especially in a young person, this may be quite debilitating. The loss of neck motion, as a result of these surgical procedures, led to the development of direct methods of internal fixation for odontoid fractures.
