Anterior atlantoaxial motion preservation fixation technique for axis complex fractures (odontoid process with Hangman’s fractures) and technique notes

Scientific Reports, 2024 · DOI: https://doi.org/10.1038/s41598-024-51367-2 · Published: January 4, 2024

Simple Explanation

This study investigates a new surgical technique, anterior atlantoaxial motion preservation fixation (AMPF), for treating complex fractures of the axis vertebra, which involves both odontoid process and Hangman’s fractures. The goal is to determine if AMPF is a feasible and effective method for these complex fractures, while also preserving the patient's ability to move their head and neck. The study retrospectively reviewed the cases of eight patients who underwent AMPF at a single hospital, documenting surgical details, complications, and patient outcomes to assess the technique's success.

Study Duration

17 Years (February 2004 to October 2021)

Participants

8 patients with axis complex fractures

Evidence Level

Retrospective study

Key Findings

1
AMPF is a feasible and effective method for simultaneously treating odontoid process and Hangman’s fractures with C2/3 instability.
2
All eight patients successfully preserved atlantoaxial movement following the AMPF surgical procedure.
3
Two patients experienced dysphagia symptoms one month after surgery, which gradually reduced with physical therapy and oral medication.

Research Summary

This study evaluated the anterior atlantoaxial motion preservation fixation (AMPF) technique for treating complex axis fractures involving both odontoid process and Hangman’s fractures. The retrospective analysis of eight patients showed that AMPF is a feasible and effective method for treating these complex fractures while preserving atlantoaxial movement. The study suggests that AMPF can be a viable alternative to posterior approaches, particularly for managing anterior longitudinal ligament issues, cervical disc problems, and intraspinal hematomas.

Practical Implications

Surgical Technique

AMPF provides a potential surgical option for complex axis fractures, offering simultaneous fracture management and motion preservation.

Patient Outcomes

The study suggests improved neurological outcomes and cervical spine stability with the use of AMPF in select patients.

Clinical Practice

The findings support the consideration of AMPF as a viable alternative to traditional posterior approaches for axis complex fractures.

Study Limitations

1
This study did not encompass axis complex injuries of type I, IIa, and type III Hangman’s fracture.
2
Elderly patients with osteoporosis were not included in this study.
3
Further exploration, with larger sample sizes and biomechanical studies, is necessary to analyze the reasons behind this limitation.

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