Treatment for odontoid fracture with C1 lateral mass and C2 pedicle screws using intraoperative orbic-3-dimensional navigation

Objective: To assess the technical advantages of intraoperative orbic-3-dimensional navigation in the treatment of odontoid fractures. Material and methods: Twelve male patients with type II or rostral type III odontoid fractures were treated with posterior C1LM-C2P screws fixation using the orbic-3D fluoroscopic navigation. The follow-up period ranged from 12 to 24 months with a mean of 19.2 months. Clinical and radiological follow-up was achieved in all patients. Indexes of patients were recorded, including operation time, complications, VAS and NDI. Results: 95.8% screws had no pedicle perforation. There were no postoperative injuries to the vertebral artery, nerve, or spinal cord. At the final follow-up, the healing rate of odontoid fracture was 83.3%. The odontoid fracture in the patient without bone graft achieved union. There was no mobile odontoid nonunion or instability of the C1-C2 articulation. The average NDI score before surgery and at the final follow-up was 75.5 ± 6.88% and 17.5 ± 6.72%, respectively. Patients who achieved odontoid fracture healing was with NDI scores of 17.4 ± 7.36% at the final follow-up (6% to 30%), while two patients of nonunion was with NDI scores of 18.0 ± 2.82% (16% to 30%) Clinical symptoms abated significantly in all patients. Conclusion: Posterior C1LM-C2P screw fixation using intraoperative Orbic-3D navigation should be considered as a treatment option for certain cases with type II or rostral type III odontoid fractures.