To assess midterm safety and efficacy of a modified Goel–Harms technique for the treatment of odontoid instabilities.
Longitudinal prospective cohort study.
Urban Level 1 Trauma Center in Southwest Germany.
Orthopaedic and neurosurgical trauma patients older than 18 years admitted for ≤24 hours.
Main Outcome Measurements:
The outcome was evaluated with respect to neurological outcome, radiological outcome and surgical complications. For the functional assessment, the EQ-5D questionnaire was used. Furthermore, the Neck Disability Index and visual analog scale for neck pain were determined. A median follow-up of 39 months (range: 6–97 months) was given.
Of the total sample (n = 56), 26 patients with an acute traumatic odontoid fracture type II underwent posterior atlantoaxial instrumentation using spinal navigation. Neck pain evaluated with visual analog scale and Neck Disability Index showed a significant decrease at final follow-up compared to preoperative values (P < 0.05). According to the EQ-5D, the valuation of quality of life after C1/C2 fusion showed an excellent outcome with complete recovery in most cases (0.7–1).
Our results demonstrate satisfactory and maintained midterm clinical and radiological results after a median follow-up of 39 months. With the use of intraoperative spinal navigation, we demonstrate a modified C1/C2 posterior fusion technique, rendering accuracy, feasibility, and overall safety.
Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.