# Finite Element Analysis of Anterior Odontoid Screw Fixation for Type II Odontoid Fractures

**Authors:** Pedro Miguel González-Vargas, Antía Millán, José Luis Thenier-Villa, Aida Badaoui, Cesáreo Conde, Juan Pou, Antonio Riveiro

PMC · DOI: 10.3390/ma19040825 · 2026-02-23

## TL;DR

This study uses computer simulations to analyze how well anterior screw fixation stabilizes type II odontoid fractures in the cervical spine.

## Contribution

The study introduces a finite element method to evaluate the biomechanical effects of anterior screw fixation in type II odontoid fractures.

## Key findings

- Screw fixation reduces vertebral displacement but increases stress and deformation compared to unfractured cases.
- Posterior oblique loads cause the highest stress at the odontoid base and screw-bone interface.
- Male patients show greater deformations and stresses under the same loading conditions.

## Abstract

Introduction: Type II odontoid process fractures are common in the adult population, and anterior screw fixation aims to restore C1–C2 complex stability while preserving cervical motion. This study focuses on the numerical analysis of odontoid fractures, evaluating the structural behavior after anterior screw fixation using finite element simulations. Methods: Forty-eight patients (males, females, 74 years old on average) diagnosed with type II odontoid fractures and treated surgically between 2015 and 2023 were included in the study. Various loading conditions (magnitude and direction) were simulated to analyze displacements and stress distributions after screw insertion. Results: Screw fixation significantly fixes fractured vertebrae, but stress and deformation are considerably larger than in unfractured cases. Posterior oblique loads produced the highest stress concentrations, particularly at the base of the odontoid and the screw-bone interface. Male models exhibited greater total deformations and stresses under the same loading conditions, suggesting relevant biomechanical differences based on sex. Conclusions: Anterior odontoid screw fixation provides effective stabilization in type II odontoid fractures, although its performance depends on factors such as load vector and patient-specific anatomical characteristics. These findings support the use of FEM simulation as a valuable tool for personalized surgical analysis.

## Full-text entities

- **Diseases:** cervical fracture (MESH:D002575), fractured vertebra (MESH:C562952), metabolic diseases (MESH:D008659), type II odontoid fracture injury (MESH:D008337), loss of bone mineral density (MESH:D001851), dens fractures (MESH:D003719), neoplastic (MESH:D009369), pseudoarthrosis (MESH:D011542), failure of (MESH:D051437), Type II Odontoid Fractures (MESH:D050723), injuries (MESH:D014947), axis (C2) fractures (OMIM:217000), Type II and Type III odontoid fractures (MESH:C536044), Fractures of the odontoid process (MESH:D000092470), postural control disorders (MESH:D007174), deformations (MESH:D009140), osteoporosis (MESH:D010024), bone loss (MESH:D001847), atlas-axis fractures (MESH:C566610), spine (MESH:D016135)
- **Chemicals:** Ti6Al4V (MESH:C031462), Odontoid (-)
- **Species:** Homo sapiens (human, species) [taxon 9606]
- **Cell lines:** S2 — Drosophila melanogaster (Fruit fly), Spontaneously immortalized cell line (CVCL_Z232)

## Figures

13 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12942386/full.md

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Source: https://tomesphere.com/paper/PMC12942386