Abstract:

Objective   To assess the clinical value of atlantoaxial transarticular screw fixation for odontoid fractures with computer navigation assisted system through comparing the clinical effects of atlantoaxial transarticular screw fixation by computer navigation assisted system (navigation group) with those of atlantoaxial transarticular screw fixation by C-arm fluoroscopy(historic control group). Methods   We retrospectively reviewed twentiy-eight patients diagnosed with odontoid fractures who underwent posterior approach atlantoaxial fusion by transarticular screw fixation. The navigation group included 13 patients and the other 15 patients were in the historic control group. Operative time,  fluoroscopy time,  blood loss and postoperative complications were compared between the two groups. We evaluated the screw accuracy through postoperative radiology examination. Results   Totally 55 atlantoaxial transarticular screws were placed in the twentiy-eight patients. The mean operative time was 154.9 min in the navigation group compared with 182.2 min in the historic control group.There was statistical difference betwe-n the two groups(P＜0.01).The mean fluoroscopy time in the navigation group was 41.3s  compared to 64.3s in the historic control group (P＜0.01). Postoperative radiographs showed all the screws were placed satisfactorily in the navigation group. The position of six screws in the historic control group was demonstrated suboptimal. Conclusion   The computer navigation assisted system enhanced safety and accuracy of atlantoaxial transarticular screw fixation,  decreased patients and surgeons’ radiation exposure and reduced operation time. This technology is an effective method for the treatment of odontoid fractures．

Key words: Atlantoaxial articulation; Screw fixation；Odontoid process；Fractures；Computer navigation