Harms technique C1–C2 fixation is a valuable choice in patients with type II odontoid fracture with failure of conservative treatment or not suitable for odontoid screw. Postoperative superficial infection reported in one patient no vertebral artery or neural injuries were noticed in our study. Three cases came with neurological affection. Neck pain with limitation of the neck movement was the complaint for the all cases. Male ratio was predominant in our study: 75% with a mean age 34.4 years. All patients underwent posterior cervical fixation C1–C2 by polyaxial screw Harms technique. All patients underwent full laboratory, medical, and neurological evaluation and imaging study on the cervical spine. Patient and methodsīetween January 2015 and January 2018, 12 patients were introduced to the neurosurgical department at the Sohag University Hospital with post-traumatic type II odontoid fracture with failure of conservative treatment and not suitable for anterior odontoid screws. We used the Frankel grading system to evaluate the postoperative neurological state. This is a retrospective case series study. Our aim in this study is to evaluate Harms technique in patients regarding pain improvement and restoration of the motor power and to report the complications. Use of polyaxial screws in Harms technique gives the best results in maintaining majority of the biomechanics. Limitation of the odontoid screws in some cases gives the chance of posterior cervical fixation to have the superior role. Odontoid fracture type II is considered an unstable fracture with a high rate of nonunion in conservative treatment. The biomechanics in the atlantoaxial joint carry more than 50% of the rotational movement which can be affected in transverse ligament tear associated with odontoid fracture type II. Type III: fracture of the body of the axis.Cervical trauma is a common cause of disability following spinal cord injury especially in athletic populations.Consider orthosis alone for elderly low-demand patients. Up to 50% nonunion with non-op treatment. Treatment = posterior C1-2 wire fixation and fusion or anterior odontoid screw fixation. Type II: fracture through the base at or just below the level of the superior articular processes.Must rule out Occipitocervical Dissociation. Type I: rare avulsion of the tip of the odontoid at the site of attachment of the alar ligament.Odontoid Fracture Classification / Treatment CT scan generally indicated to further define fracture.Odontoid Fracture Xray / Diagnositc Tests Level of spinal injury can not be determined until bulbocaverosus reflex has returned. Absence of the bulbocaverosus reflex indicates spinal shock.Complete neuro exam: motor strength, pin-prick sensation, reflexes, cranial nerves, rectal examination (perineal pin-prick sensation, sphincter tone, volitional spincter control).Palpate entire spine for tenderness / step off.High energy trauma in young patients, low0energy in elderly patients.Mechanism of injury not clearly defined.Odontoid Fracture Etiology / Epidemiology / Natural History S12.101A Unspecified nondisplaced fracture of second cervical vertebra, initial encounter for closed fracture.S12.100A Unspecified displaced fracture of second cervical vertebra, initial encounter for closed fracture.Etiology / Epidemiology / Natural HistoryĪssociated Injuries / Differential Diagnosis
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