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22대 대한민국 국회 국회정보길라잡이 국회의원검색
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Objective: Anterior odontoid screw fixation (AOSF) has several advantages over posterior C1–2 fusion for Grauer type II and shallow type III odontoid fractures. However, the risk factors for fusion failure, particularly in terms of 3-dimensional (3D) measurements, remain unclear. This study investigated the impact of fracture deficit volume (FDV), a novel 3D measurement, on fusion outcomes in patients undergoing AOSF.

Methods: We enrolled 44 patients with Grauer type II or shallow type III odontoid fractures treated with AOSF at a single institution. Radiological assessments included preoperative and postoperative measurements of the fracture gap and fracture displacement on computed tomography (CT) scans. FDV was calculated through 3D CT reconstruction of preoperative and immediate postoperative CT to quantify the spatial gap between the edges of the fractures. Fusion outcomes were defined as solid union, fibrous union, or nonunion. Logistic regression and a generalized additive model (GAM) were used to identify risk factors for fusion failure after AOSF.

Results: Solid fusion was achieved in 77.3% of patients. A reduction in the FDV with respect to the preoperative value was significantly associated with successful fusion (p = 0.028), whereas patients presenting an increased FDV postoperatively were more likely to exhibit fusion failure (p = 0.006). Age ≥ 65 years, a fracture gap ≥ 2 mm, and an increased FDV postoperatively were significant risk factors for fusion failure. GAM analysis revealed a linear relationship between a reduced FDV and improved fusion rates (adjusted R2 = 0.186, p = 0.018).

Conclusion: The risk of fusion failure is greater in elderly patients, those with a fracture gap greater than 2 mm, and those with an increased FDV postoperatively. Among the modifiable risk factors, FDV had the greatest impact on fusion outcomes after AOSF.

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Impact of fracture deficit volume on fusion success in anterior odontoid screw fixation JinWoo Jung, Young San Ko, Yu Sung Yoon, Dae-Chul Cho p. 859-869
(A) novel clinical insight into idiopathic syringomyelia with occult arachnoid webs : neuropathological features, differential diagnosis, and surgical strategy Chunli Lu, Min Yin, Fan Yuan, Chenyuan Ding, Xingwen Wang, Fengzeng Jian p. 846-858
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Long fiber type carbon fiber reinforced plastic pedicle screws exhibit high strength, comparable to titanium-alloy screws, and are resistant to loosening Kohei Morita, Hiroki Ohashi, Kenji Tsuchida, Yasuhiro Furuta, Satoshi Tani, Kostadin Karagiozov, Yuichi Murayama p. 774-783
Biomechanical impact of cement augmentation on pedicle screw fixation and adjacent segment disease in multilevel lumbar fusion : a finite element analysis Min-Young Jo, Sung-Jae Lee, Je-Hoon An, Young-Hoon Kim, Jun-Seok Lee, Hyung-Youl Park p. 763-773
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Chiari malformation and hindbrain descent : characterization and new classification based on mechanism and pathogenesis, and surgical management Misao Nishikawa, Paolo A. Bolognese, Masaki Yoshimura, Kentarou Naito, Noritsugu Kunihiro, Hiromichi Ikuno, Mitsuhiro Hara, Hiroaki Sakamoto, Kenji Ohata, Takeo Goto p. 696-712
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