Minimally invasive percutaneous anterior odontoid screw fixation: institutional experience with a simple and effective technique

BACKGROUND: The aim of this paper was to show a novel modified technique to perform minimally invasive anterior odontoid screw fixation. METHODS: Twenty-nine patients with a mean age of 45 years were treated with a modified percutaneous anterior odontoid screw fixation. All patients were affected by type II or rostral shallow type III odontoid fractures. A modified guide tube was used in all these patients, with reduction of soft tissue dissection for percutaneous approach. RESULTS: There were no complications related to the modified technique. Good results and optimal screw placement were achieved in 28 out of 29 patients. Only in 1 patient we observed, after mobilization, screw displacement, probably due to severe osteoporosis. CONCLUSIONS: In our opinion, this modified percutaneous minimally invasive technique for anterior odontoid screw fixation, along with the use of a soft tissue dilator not fixed to the spine, has not yet been reported in literature and is strongly recommended to reduce invasiveness of odontoid screw placement.