Odontoid fracture dynamic compression apparatus and method
View Patent ↗A cervical fixation system and method for repairing odontoid fractures includes securing an anterior plate to caudal portion of C2 body below the odontoid neck. The anterior plate houses lag screw within a posterior shaft. A cannulated fixation device crosses the fracture site with fixation into the cephalad fragment. The lag screw can be pulled caudally into the plate with a compression screw to apply a compression force across the fracture site.
1. A method comprising:
exposing at least a portion of a cervical spine of an associated patient;
placing a guide wire through a portion of a second cervical (C2) body cephalad into an odontoid of the C2 body across a fracture site;
forming a void into at least a portion of the C2 body and the odontoid using a cannulated step drill to form a hole in a caudal to cephalad direction of the tip of the odontoid over the guide wire with the wider step of the cannulated drill coming out the anterior inferior back of the C2 body;
placing a cannulated lag screw into the odontoid over the guide wire;
placing an anterior plate onto an inferior surface of the C2 body, wherein the plate includes a plate surface configured to be secured to at least a portion of a surface of the C2 body of the associated patient's cervical spine, wherein the plate includes a plurality voids formed in the plate, wherein the voids are positioned to allow fixation of the plate to the C2 body and the plate further includes a shaft coupled to a posterior surface of the plate, wherein the anterior plate is placed in such a manner to have the cannulated lag screw aligned with the shaft;
securing the anterior plate to the surface of the C2 body through one or more of the voids with one or more fastening devices; and
applying a compressive force from a compression screw threaded into an inferior shaft of the lag screw, wherein as a head of the compression screw contacts an inferior edge of the anterior plate, the lag screw is pulled in a caudal direction through the shaft to apply a compressive force between the odontoid of the C2 body and the C2 body.
2. The method of claim 1 , biplane fluoroscopy is performed to guide placement of at least one of the guide wire, the lag screw or the anterior plate.
3. The method of claim 1 further including after placement of the guide wire, a second wire is placed for de-rotation of the odontoid.
4. The method of claim 3 further including adjusting alignment of the odontoid to an anatomically desired position.
5. The method of claim 1 , further including determining a length for the cannulated lag screw by using a depth gauge coupled over the guide wire prior to forming a void in the associated patient's spine.
6. A method comprising:
exposing at least a portion of a cervical spine of an associated patient;
placing a guide wire through a portion of a second cervical (C2) body cephalad into an odontoid of the C2 body across a fracture site, after placement of the guide wire, a second wire is placed for de-rotation of the odontoid;
forming a void into at least a portion of the C2 body and the odontoid;
placing a cannulated lag screw into the odontoid over the guide wire;
placing an anterior plate onto an inferior surface of the C2 body, wherein the plate includes a plate surface configured to be secured to at least a portion of a surface of the C2 body of the associated patient's cervical spine, wherein the plate includes a plurality voids formed in the plate, wherein the voids are positioned to allow fixation of the plate to the C2 body and the plate further includes a shaft coupled to a posterior surface of the plate, wherein the anterior plate is placed in such a manner to have the cannulated lag screw aligned with the shaft;
securing the anterior plate to the surface of the C2 body through one or more of the voids with one or more fastening devices; and
applying a compressive force from a compression screw threaded into an inferior shaft of the lag screw, wherein as a head of the compression screw contacts an inferior edge of the anterior plate, the lag screw is pulled in a caudal direction through the shaft to apply a compressive force between the odontoid of the C2 body and the C2 body.
7. The method of claim 6 , biplane fluoroscopy is performed to guide placement of at least one of the guide wire, the lag screw or the anterior plate.
8. The method of claim 6 further including adjusting alignment of the odontoid to an anatomically desired position.
9. The method of claim 6 , further including determining a length for the cannulated lag screw by using a depth gauge coupled over the guide wire prior to forming a void in the associated patient's spine.