C2 Dens (Odontoid) Fractures: Understanding Odontoid Screw Fixation Surgery

What Exactly is an Odontoid Fracture?

Think of your neck as a stack of building blocks. The second vertebra from the top (called C2) has a small peg-like projection that acts like a pivot point, allowing your head to rotate left and right. This projection is called the odontoid process, and when it breaks, it's called an odontoid fracture.

This injury is serious because:

• It can make your neck unstable

• It may cause severe pain and limit head movement

• In rare cases, it can affect the spinal cord if left untreated

Types of Odontoid Fractures

Classification is based on where the break occurs, with three main types:

• Type I: A break at the very tip (uncommon)

• Type II: A break at the base where the peg meets the vertebra (most common and often requires surgery)

• Type III: A break that extends into the main body of the vertebra (often heals without surgery)

• Type II fractures are the most concerning because they tend to heal poorly on their own and may require surgical intervention.

Advanced Diagnosis at MIRSS

Accurate diagnosis is crucial for determining the best treatment approach. At MIRSS, we utilize advanced imaging technologies to precisely evaluate your fracture:

• High-resolution CT scans provide detailed images of the bone structure and fracture pattern

• MRI scans help assess soft tissue damage and spinal cord involvement

• Intraoperative 3D CT allows our surgeons to plan the optimal treatment approach

This comprehensive imaging helps our team determine whether your fracture requires surgical intervention and, if so, which approach will provide the best outcome.

How Do We Decide on Treatment?

Your treatment depends on several factors:

• Type and location of the fracture

• How displaced (moved apart) the broken pieces are

• Your age and overall health

• Quality of your bone

How recently the injury occurred

Non-Surgical Options

• Cervical Collar - For stable fractures, a rigid neck collar worn for 8-12 weeks may allow natural healing. However, success rates vary, and close monitoring is essential.

• Halo Vest - This involves a ring attached to your skull with pins, connected to a vest on your chest. While effective for keeping the neck completely still, it's uncomfortable and limits daily activities significantly.

Surgical Options

• Posterior Fusion (Back Approach) - This surgery connects the first and second neck vertebrae from behind using rods and screws. While very stable, it does reduce your ability to rotate your head.

• Odontoid Screw Fixation (Front Approach) - This procedure places screws directly through the broken bone to hold it together while it heals. The major advantage is that it preserves most of your natural neck movement.

Odontoid Screw Fixation: A Closer Look

This surgery is often recommended for Type II fractures that are:

• Recently occurred (within a few months)

• Well-aligned

• In patients with good bone quality

What Makes This Surgery Appealing?

Unlike fusion surgeries that limit neck rotation, odontoid screw fixation aims to:

Restore stability to the fracture
Preserve your natural head and neck movement
Allow faster return to activities
Avoid the need for rigid bracing after surgery

Advanced Surgical Technology at MIRSS

At MIRSS, we employ cutting-edge technology to enhance surgical precision and patient safety:

Robotic-Assisted Surgery

Our MazorX Stealth Edition (Medtronic) – a 3rd generation spine robot with integrated navigation capabilities – provides:

• Enhanced accuracy in screw placement

• Real-time surgical guidance

• Reduced radiation exposure

• Improved surgical outcomes

Intraoperative Imaging

Intraoperative navigation during surgery allows:

• Real-time verification of screw placement

• Immediate correction if needed

• Reduced need for revision surgeries

Specialized Surgical Environment

Our state-of-the-art modular operating theaters are designed specifically for spine surgeries, featuring:

• Advanced imaging integration

• Optimal lighting and positioning systems

• Sterile, controlled environment

The Surgical Process at MIRSS

Before Surgery

Your surgical team will:

• Obtain detailed CT scans to plan the exact screw placement using robotic planning software

• Review your medical history with our dedicated spine anesthesia team

• Discuss the procedure, risks, and expected outcomes

During Surgery

The procedure typically takes 1-2 hours and involves:

• Anesthesia: Our specialized spine anesthesia team ensures your comfort and safety throughout the procedure.

• Positioning: You'll be placed on your back with your neck slightly extended in our modular operating theater.

• Incision: A small horizontal incision (approximately 1 inch) is made at the front of your lower neck.

• Robotic-Guided Screw Placement: Using the MazorX robotic system and intraoperative cone beam CT imaging, the surgeon precisely places one or two screws through the broken bone to compress and stabilize the fracture.

• Neuromonitoring: Throughout the procedure, intraoperative neuromonitoring continuously tracks nerve function to ensure your safety.

• Closure: The incision is closed with sutures and covered with a sterile dressing.

Our specialized OR staff trained specifically in spine surgeries work as a coordinated team to ensure optimal outcomes.

Recovery: What to Expect

In the Hospital

• Most patients stay 1 day after surgery

• Pain is typically manageable with oral medications

• We don't recommend wearing any collar for most patients

• Our nursing staff monitors your recovery closely

Rehabilitation with MIRSS

Our dedicated spine physiotherapy team creates a personalized recovery plan:

First 2 Weeks:

• Gentle neck exercises as appropriate

• Wound care instructions

• Activity modifications

• Pain management strategies

Weeks 2-6:

• Progressive strengthening exercises

• Gradual return to daily activities

• Regular follow-up appointments

Months 2-3:

• Advanced rehabilitation exercises

• Return to work and sports activities as appropriate

• Long-term maintenance strategies

Follow-Up Care

Regular follow-up appointments include:

• Clinical examinations

• Imaging studies to monitor bone healing

• Adjustment of activity levels based on recovery progress

Warning Signs to Watch For

Contact your doctor immediately if you experience:

• Increasing neck pain or new neurological symptoms

• Signs of infection (fever, increased redness, drainage from incision)

• Difficulty swallowing or breathing

• Numbness or weakness in arms or hands

Success Rates and Outcomes

When performed by experienced surgeons using advanced technology, odontoid screw fixation has high success rates. Most patients experience:

• Significant pain relief within weeks

• Return to normal activities within 2-3 months

• Preservation of neck rotation

• Solid bone healing

However, like any surgery, there are risks including infection, bleeding, nerve injury, and the possibility that the fracture may not heal properly.

Why Choose MIRSS for Your Spine Care?

Comprehensive Expertise

• Experienced spine surgeons specializing in complex cervical procedures

• Multidisciplinary team including dedicated anesthesia and physiotherapy specialists

• Specialized OR staff trained specifically in spine surgery protocols

Advanced Technology

• 3rd generation robotic surgery with integrated navigation

• Intraoperative high-resolution imaging for real-time surgical guidance

• Comprehensive neuromonitoring for enhanced safety

• State-of-the-art modular operating theaters designed for spine procedures

Patient-Centered Care

• Personalized treatment plans based on your specific condition

• Dedicated teams for each aspect of your care

• Comprehensive rehabilitation programs

• Ongoing support throughout your recovery journey

Questions to Ask Your Doctor

Before making treatment decisions, consider asking:

• Am I a good candidate for odontoid screw fixation?

• What are the risks and benefits compared to other treatments?

• How will robotic assistance benefit my specific case?

• What should I expect during recovery?

• When can I return to my normal activities?

Moving Forward

An odontoid fracture is a serious injury, but with proper treatment using advanced surgical techniques, most people can expect to return to their previous level of activity. The combination of experienced surgical teams and cutting-edge technology at specialized spine centers in Bangalore can significantly improve outcomes and recovery times.

At MIRSS (Manipal Institute of Robotic Spine Surgery), Bangalore, we combine the latest in robotic surgical technology with specialized expertise and comprehensive care teams. Our integrated approach – from advanced diagnostic imaging to specialized rehabilitation – is designed to provide you with the best possible outcome and fastest recovery.

From your initial consultation through complete recovery, our dedicated teams in Bangalore work together to support you on your journey back to health and active living.