Teriparatide anabolic therapy as potential treatment of type Ⅱ dens non-union fractures

作     者：Enrico Pola Virginia Pambianco Debora Colangelo Virginia M Formica Giovanni Autore Luigi A Nasto 

作者机构：Spinal UnitDepartment of Orthopaedics and Traumatology"A.Gemelli" University HospitalCatholic University of Rome Centre for Spine Studies and SurgeryQueen’sMedical CentreNottingham University Hospitals NHS Trust 

出 版 物：《World Journal of Orthopedics》 (世界骨科杂志（英文版）)

年 卷 期：2017年第8卷第1期

页      面：82-86页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Type Ⅱ odontoid fractures Non-union Anabolic therapy Teriparatide Fracture healing 

摘      要：Odontoid fractures account for 5% to 15% of all cervical spine injuries and 1% to 2% of all spine fractures. Type Ⅱ fractures are the most common fracture pattern in elderly patients. Treatment(rigid and non-rigid immobilization, anterior screw fixation of the odontoid and posterior C1-C2 fusion) remains controversial and represents a unique challenge for the treating surgeon. The aims of treatment in the elderly is to quickly restore pre-injury function while decreasing morbidity and mortality associated with inactivity, immobilization with rigid collar and prolonged hospitalization. Conservative treatment of type Ⅱ odontoid fractures is associated with relatively high rates of non-union and in a few cases delayed instability. Options for treatment of symptomatic non-unions include surgical fixation or prolonged rigid immobilization. In this report we present the case of a 73-year-old woman with post-traumatic odontoid nonunion successfully treated with Teriparatide systemic anabolic therapy. Complete fusion and resolution of the symptoms was achieved 12 wk after the onset of the treatment. Several animal and clinical studies have confirmed the potential role of Teriparatide in enhancing fracture healing. Our case suggests that Teriparatide may have a role in improving fusion rates of C2 fractures in elderly patients.