Odontoid fractures above C2 to pelvis posterior instrumented fusions: a single center's 11-year experience.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: None relevant to the submitted work. 13. J Craniovertebr Junction Spine. 2025 Apr-Jun;16(2):126-132. doi: 10.4103/jcvjs.jcvjs_42_25. Epub 2025 Jul 3. A Comparison of different posterior arthrodesis techniques versus anterior dens screw for odontoid fractures: A systematic review and meta-analysis. Texakalidis P(1), Matsoukas S(2), Cloney M(3), Krushelnytskyy M(1), Swong K(1), El Tecle N(1), Koski T(1), Dahdaleh NS(1). Author information: (1)Department of Neurosurgery, Northwestern Memorial Hospital, Chicago, IL, USA. (2)Department of Neurosurgery, Thomas Jefferson University Hospital, Philadeplhia, PA. (3)Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA. BACKGROUND AND OBJECTIVES: Odontoid fractures are often managed surgically. The most common approaches are anterior dens screw (ADS) and posterior arthrodesis (PA), with the latter being associated with significantly higher fusion rates. PA techniques can include wiring, C1-C2 transarticular (TA) screws, and C1 lateral mass (LM)-C2 pars/pedicle screws. Most comparative studies group multiple PA techniques together when comparing PA versus ADS. Our objective was to systematically review the literature and identify studies that separately provide fusion rates of each different posterior C1-C2 arthrodesis (PA) technique utilized compared to ADS. METHODS: A systematic literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A random effects meta-analysis was performed, and the I2 statistic was used to assess heterogeneity. RESULTS: In total, 15 studies comprising 685 patients (ADS: 377; wiring: 58; TA: 150; C1 LM-C2 pars/pedicle screws: 100). The average age of the patients ranged across the included studies between 22 and 82.4 years old. The mean last follow-up was >12 months in eight studies. Only two studies reported a follow-up period of