While odontoid fractures are common injuries, disagreement exists regarding treatment. Some authors claim a high rate of pseudoarthrosis and have therefore recommended early posterior fixation and fusion. This, however, results in decreased cervical rotation. Therefore, it has been recommended that a more direct approach to the fracture be taken. Results on anterior screw fixation in 14 patients are reported. The technique was found to be especially useful in multiple trauma patients, patients who refuse halo treatment, and in some nonunions.
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[Treatment of geriatric odontoid fractures].
Unfallchirurgie (Heidelb)
January 2025
Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Freiburg, Hugstetter Straße 55, 79106, Freiburg, Deutschland.
The treatment of odontoid fractures in geriatric patients, particularly type II fractures, remains controversial. In biologically young patients, studies suggest advantages of surgical treatment in terms of mortality; however, this advantage is not observed in geriatric patients. While the mortality appears to be higher after conservative treatment in patients aged 65-80 years, there are studies that have shown no differences in mortality for patients aged 80 years or older and even showed advantages of conservative treatment in this age group.
View Article and Find Full Text PDFTransoral C2 osteotomy for treatment of severe irreducible atlantoaxial dislocation after odontoid fracture: about 3 cases.
Neurochirurgie
January 2025
Department of Neurosurgery, Hôpital de la Timone, APHM. 264 rue Saint-Pierre, 13005, Marseille, France. Electronic address:
Objective: To report the outcomes of transoral C2 osteotomy (or partial odontoidectomy) and posterior fixation, regarding efficacy and safety, in patients with severe irreducible atlantoaxial dislocation (IAAD) following odontoid fracture.
Methods: Transoral C2 osteotomy, soft tissue resection, with or without facet joint release, followed by posterior fixation were performed on 3 patients (2012, 2016, 2023) who were suffering from severe IAAD after an odontoid fracture with spinal cord compression. The radiological and clinical outcomes were then assessed.
Challenges of Treating a C2 Odontoid Fracture in an Elderly Patient With Multiple Comorbidities: A Case Report.
Cureus
December 2024
Department of Osteopathic Manipulative Medicine, Liberty University College of Osteopathic Medicine, Lynchburg, USA.
An 88-year-old male with a history of cervical spondylosis (status post laminectomy of C2-C3 and laminoplasty of C4-C5), chronic congestive heart failure (CHF), pulmonary embolism, and lumbar spinal stenosis presented to an outpatient sports medicine clinic with neck pain following a fall five days prior due to loss of balance. He reported pain on the left side worsened by movement and accompanied by neck "clicking." A physical exam showed severe limitation in cervical spine extension limited by pain and loss of lordotic curve and a neurologic exam demonstrated weakness in the left leg secondary to a previous back surgery.
View Article and Find Full Text PDFEvaluation of postoperative drainage necessity in posterior atlantoaxial fixation via intermuscular approach for odontoid fracture.
Sci Rep
January 2025
Department of Orthopedics, Shanghai Changzheng Hospital, Naval Medical University, 415 Fengyang Road, Huangpu District, Shanghai, 200003, People's Republic of China.
The necessity of routinely placing closed suction wound drainage in spinal surgery has been questioned. This study aims to assess if closed suction wound drainage is necessary for posterior atlantoaxial fixation via intermuscular approach. The functional outcomes of these 40 patients who underwent posterior atlantoaxial fixation via intermuscular approach without drainage tube (Group A) were compared with that of a control group, which consisted of 68 randomly enrolled cases with posterior atlantoaxial fixation via intermuscular approach with drainage tube (Group B).
View Article and Find Full Text PDFMalunion in a Self-stabilized Fracture of the Odontoid Process Type II with a Chronic Anterior Atlantoaxial Subluxation in a Neurologically Intact Patient: A Case Report.
Rev Bras Ortop (Sao Paulo)
November 2024
Serviço de Cirurgia de Coluna, Instituto Nacional de Rehabilitación, Cidade do México, México.
Atalanto-occipital dislocations with type II fractures of the odontoid process are rare, reporting 7 cases for every 784 upper cervical spine injuries, an incidence of <0.3% and are related to a high rate of morbidity and mortality. Regarding C2 fractures, the most common are in the odontoid process, representing 7%, classified by Anderson and D'Alonso according to their level, with the highest rate of pseudarthrosis in zone II of up to 85% are caused mainly by car accidents.
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