scholarly journals Atraumatic Occult Odontoid Fracture in Patients with Osteoporosis-Associated Thoracic Kyphotic Deformity: Report of a Case and Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Kanji Mori ◽  
Kazuya Nishizawa ◽  
Akira Nakamura ◽  
Shinji Imai
Keyword(s):  
Traumatic Event ◽  
Present Report ◽  
Odontoid Process ◽  
Odontoid Fracture ◽  
Kyphotic Deformity ◽  
Diagnostic Challenge ◽  
Odontoid Fractures ◽  
Type Iii ◽  
Intensity Changes ◽  
Standard Radiographs

Anderson type II odontoid fractures are reported to be the most common injury of the odontoid process in patients over the age of 65. However, atraumatic occult Anderson type III odontoid fractures have been rarely described and remain a diagnostic challenge. In the present report, we illustrate a 78-year-old female with osteoporosis-associated marked thoracic kyphotic deformity who developed atraumatic Anderson type III occult odontoid fracture and raise awareness of this condition. Anteroposterior and lateral standard radiographs of cervical spine failed to disclose odontoid fracture. Magnetic resonance imaging demonstrated intensity changes of the axis. Subsequent computed tomography clearly demonstrated Anderson type III odontoid fracture. Conservative treatment achieved complete bone union without neurological deteriorations. At 3-year follow-up, the patient was doing well without neurological and radiological deteriorations. Even if the patients have no traumatic event, we have to keep odontoid fractures in our mind as one of the differential diagnoses when we encounter elderly patients with neck pain, especially in patients with osteoporosis-associated marked thoracic kyphotic deformity.

Longitudinal atlantoaxial dislocation with type III odontoid fracture

1996 ◽  
Vol 84 (4) ◽  
pp. 666-670 ◽  
Author(s):  
Gregory J. Przybylski ◽  
William C. Welch
Keyword(s):  
Odontoid Fracture ◽  
Spine Injury ◽  
Upper Cervical Spine ◽  
Skeletal Traction ◽  
Radiographic Findings ◽  
Content Type ◽  
Odontoid Fractures ◽  
Type Iii ◽  
Upper Cervical ◽  
Injury Treatment

✓ Odontoid fractures are a common traumatic upper cervical spine injury. Treatment of Type III odontoid fractures includes skeletal traction for realignment and halo vest immobilization. The authors report an unusual case of severe atlantoaxial ligamentous disruption accompanying a traumatic Type III odontoid fracture. Five pounds of skeletal traction was associated with marked neurological deterioration from unanticipated longitudinal instability. Radiographic findings were identified that were suggestive of extensive ligamentous disruption. Recommendations for individualized patient management are given in the context of related literature.

scholarly journals Therapeutic management in an elderly patient with odontoid fracture

2016 ◽  
Vol 16 (4) ◽  
pp. 201-207
Author(s):  
Wojciech Ilków ◽  
◽  
Tomasz Krzeszowiec ◽  
Dariusz Łątka ◽  
◽  
...  
Keyword(s):  
Cervical Spine ◽  
Odontoid Process ◽  
The Elderly ◽  
Common Type ◽  
Odontoid Fracture ◽  
Therapeutic Management ◽  
Cervical Spine Fracture ◽  
Odontoid Fractures ◽  
Regional Medical ◽  
Comprehensive Discussion

Fracture of the odontoid process is the most common type of cervical spine fracture in elderly patients (i.e. population over the age of 70 years), which can lead to disability or death. The therapeutic management depends on imaging findings and patient’s general condition. The authors present a case of a 71-year-old patient diagnosed with odontoid fracture based on cervical spine computed tomography, who received surgical treatment in the Department of Neurosurgery of the Regional Medical Centre in Opole. The problem of odontoid fractures in the elderly has been a subject of a comprehensive discussion.

Biomechanical Aspects of Odontoid Fracture Etiology: A Finite Element Investigation

1999 ◽  
Author(s):  
Christian M. Puttlitz ◽  
Vijay K. Goel ◽  
Charles R. Clark
Keyword(s):  
Odontoid Process ◽  
Cervical Vertebra ◽  
Odontoid Fracture ◽  
Type I ◽  
Spine Fractures ◽  
Type Ii ◽  
Body Type ◽  
Avulsion Fractures ◽  
Type Iii ◽  
Cervical Spine Fractures

Abstract Fractures of the odontoid process of the second cervical vertebra comprise 7–13% of all cervical spine fractures. Anderson and D’Alzono [1974] have classified these fractures into three categories: Type I, Type II, and Type III. Type I fractures are oblique, usually avulsion, fractures of the superior-most aspect of the odontoid. Type II fractures, the most commonly-occurring, are produced at the juxtaposition of the process and the C2 body. Type III fractures involve propagation of the fracture through the C2 body.

SURGICAL MANAGEMENT OF ODONTOID FRACTURES, AN INSTITUTIONAL EXPERIENCE.

2021 ◽  
pp. 45-47
Author(s):  
B.D. B.S. Naik ◽  
M.V. Vijayasekhar ◽  
P Prahaladhu ◽  
K Satyavaraprasad ◽  
Nikhil Tadwalkar
Keyword(s):  
Cervical Spine ◽  
Odontoid Process ◽  
Odontoid Fracture ◽  
Common Mechanism ◽  
Type I ◽  
Type Ii ◽  
Odontoid Fractures ◽  
Transoral Odontoidectomy ◽  
King George Hospital ◽  
A Prospective Study

Introduction- Odontoid fractures occur as a result of high impact trauma to the cervical spine. Hyperextension of the cervical spine is The most common mechanism of injury. Odontoid fractures occurs in 10 to 15% of all cervical spine fractures . Fracture of the odontoid process is classied into one of three types which are type I, type II, or type III fractures. Of all the types of odontoid fractures, type II is the most common and accounts for over 50% of all odontoid fractures . Materials and Methods- This is a prospective study conducted over 2 years in Neurosurgery Department, Andhra Medical College & King George Hospital, Visakhapatnam. Result: A total of 18 odontoid fractures were managed in the period of two years, out of which 2 were kept conservative and 16 were operated. Out of 16, 11were operated with odontoid screw and 2 underwent C1-C2 xation and 3 patients underwent Transoral Odontoidectomy with posterior occipito-cervical xation Conclusion: The treatment of odontoid fracture is complex and should be planned according to the type of odontoid fracture and neurological decit. Odontoid screw will sufce in patients with type II fracture with undisplaced fragments. Posterior C1-C2 xation is a better choice for complex odontoid fractures. Transoral odontoidectomy and occipito-cervical xation is reserved as the last option.

Delayed Neurological Deficit after Traumatic Odontoid Fracture

2018 ◽  
Vol 1 (2) ◽  
Author(s):  
Yesaya Yunus ◽  
Julius July ◽  
Lutfi Hendriansyah
Keyword(s):  
Neurological Deficit ◽  
Significant Risk ◽  
Odontoid Process ◽  
Odontoid Fracture ◽  
Atlantoaxial Dislocation ◽  
Neurological Deficits ◽  
Odontoid Fractures ◽  
Neurological Improvement ◽  
Cord Injury ◽  
Cervical Traction

Fractures of the odontoid process can lead to gross instability of the atlantoaxial complex and present a significant risk for a potentially catastrophic spinal cord injury. Type II odontoid fractures are the most common odontoid fractures and are unstable that may displace anteriorly or posteriorly.  If left untreated, the patient may develop atlantoaxial dislocation that causes neurological deficit also progressive myelopathy.We described the surgical management of four patients with a delayed neurological deficit after odontoid fracture with a history of trauma and after triggered by traditional massage. Traction several days before operation applied to achieve reduction of atlantoaxial dislocation.Posterior instrumentation and correction of atlantoaxial dislocation were performed with interarticular screw fixation (Harm technique) in all of the patients.All of the four patients showed a reduction of the atlantoaxial dislocation and also a neurological improvement. Cervical traction followed by posterior instrumented correction may be an effective alternative to treating delayed neurological deficits after traumatic odontoid fracture.

Delayed Neurological Deficit after Traumatic Odontoid Fracture

2018 ◽  
Vol 1 (2) ◽  
pp. 22
Author(s):  
Yesaya Yunus ◽  
Julius July
Keyword(s):  
Neurological Deficit ◽  
Significant Risk ◽  
Odontoid Process ◽  
Odontoid Fracture ◽  
Atlantoaxial Dislocation ◽  
Neurological Deficits ◽  
Odontoid Fractures ◽  
Neurological Improvement ◽  
Cord Injury ◽  
Cervical Traction

Fractures of the odontoid process can lead to gross instability of the atlantoaxial complex and present a significant risk for a potentially catastrophic spinal cord injury. Type II odontoid fractures are the most common odontoid fractures and are unstable that may displace anteriorly or posteriorly.  If left untreated, the patient may develop atlantoaxial dislocation that causes neurological deficit also progressive myelopathy.We described the surgical management of four patients with a delayed neurological deficit after odontoid fracture with a history of trauma and after triggered by traditional massage. Traction several days before operation applied to achieve reduction of atlantoaxial dislocation.Posterior instrumentation and correction of atlantoaxial dislocation were performed with interarticular screw fixation (Harm technique) in all of the patients.All of the four patients showed a reduction of the atlantoaxial dislocation and also a neurological improvement. Cervical traction followed by posterior instrumented correction may be an effective alternative to treating delayed neurological deficits after traumatic odontoid fracture. 

scholarly journals Evidence-based analysis of odontoid fracture management

2000 ◽  
Vol 8 (6) ◽  
pp. 1-6 ◽  
Author(s):  
Terrence D. Julien ◽  
Bruce Frankel ◽  
Vincent C. Traynelis ◽  
Timothy C. Ryken
Keyword(s):  
Selection Criteria ◽  
Odontoid Fracture ◽  
Evidence Based ◽  
Type I ◽  
Type Ii ◽  
Fracture Type ◽  
Class Iii ◽  
Odontoid Fractures ◽  
Type Iii ◽  
Fracture Management

Object The management of odontoid fractures remains controversial. Evidence-based methodology was used to review the published data on odontoid fracture management to determine the state of the current practices reported in the literature. Methods The Medline literature (1966–1999) was searched using the keywords “odontoid,” “odontoid fracture,” and “cervical fracture” and graded using a four-tiered system. Those articles meeting selection criteria were divided in an attempt to formulate practice guidelines and standards or options for each fracture type. Evidentiary tables were constructed by treatment type. Ninety-five articles were reviewed. Five articles for Type I, 16 for Type II, and 14 for Type III odontoid fractures met selection criteria. All studies reviewed contained Class III data (American Medical Association data classification). Conclusions There is insufficient evidence to establish a standard or guideline for odontoid fracture management. Given the extent of Class III evidence and outcomes reported on Type I and Type III fractures, a well-designed case-controlled study would appear to provide sufficient evidence to establish a practice guideline, suggesting that cervical immobilization for 6 to 8 weeks is appropriate management. In cases of Type II fracture, analysis of the Class III evidence suggests that both operative and nonoperative management remain treatment options. A randomized trial or serial case-controlled studies will be required to establish either a guideline or treatment standard for this fracture type.

Traumatic Type III odontoid fracture and severe rotatory atlantoaxial subluxation in a 3-year-old child

2010 ◽  
Vol 5 (2) ◽  
pp. 200-203 ◽  
Author(s):  
David Panczykowski ◽  
Andrew N. Nemecek ◽  
Nathan R. Selden
Keyword(s):  
Motor Vehicle ◽  
Odontoid Process ◽  
Odontoid Fracture ◽  
Motor Vehicle Crash ◽  
Lateral Mass ◽  
Cervical Spine Injuries ◽  
Type Iii ◽  
Spine Injuries ◽  
True Type ◽  
Rotatory Subluxation

In this report, the authors describe the case of a 3-year-old child with a traumatic Type III odontoid fracture. To their knowledge, this is the first reported case of a true Type III odontoid fracture with atlantoaxial rotatory subluxation in a child. The patient presented with pain and had resisted manipulation of the neck following a motor vehicle crash. Plain cervical radiographs revealed an odontoid fracture, which was confirmed by CT imaging. The left lateral mass of C-1 was rotated anterior to that of C-2 with the displaced odontoid process acting as the pivot point of rotation. The C1–2 alignment was normalized, and the C-2 fracture was reduced completely. The regional anatomy and mechanism of injury, radiographic diagnosis, and management of cervical spine injuries in children are discussed.

Vertically Unstable Type Iii Odontoid Fractures: Case Report

Neurosurgery ◽  
2006 ◽  
Vol 58 (4) ◽  
pp. E797-E797 ◽  
Author(s):  
Andrew Jea ◽  
Claudio Tatsui ◽  
Hamad Farhat ◽  
Steve Vanni ◽  
Allan D. Levi
Keyword(s):  
Odontoid Fracture ◽  
Iliac Crest Bone Graft ◽  
Odontoid Fractures ◽  
Type Iii ◽  
Trauma Service ◽  
Life Threatening ◽  
Delayed Recognition ◽  
High Level ◽  
Neurological Injuries ◽  
C2 Fixation

Abstract OBJECTIVE AND IMPORTANCE: Type III odontoid fractures are generally thought of as unstable fractures that can be successfully treated with an external orthosis. However, there is a rare subtype of Type III odontoid fractures that is similar in the degree of instability to atlanto-occipital dislocation injuries. Not recognizing or not treating this injury urgently and aggressively could lead to devastating iatrogenic neurological injuries such as quadriplegia and fatal lower brainstem palsies. CLINICAL PRESENTATION: We present the case of a 73-year-old woman with a vertically distracted Type III odontoid fracture and associated quadriparesis and brainstem deficits. The patient was kept in a rigid collar, placed in a kinematic bed, and admitted to the trauma service for the management of her life-threatening systemic injuries. Traction was not applied. INTERVENTION: As soon as the patient was systemically stable, she was taken to the operating room for C1–C2 fixation with a screw-rod construct supplemented by cable and structural iliac crest bone graft. CONCLUSION: Delayed recognition of this subtype of Type III odontoid fracture could have fatal or highly morbid consequences, such as quadriparesis/-plegia, lower brainstem dysfunction, and ventilator-dependence, for the patient. It is important to keep a high level of suspicion for this unusual subtype of Type III odontoid fracture.

scholarly journals Proposal of a new method for treating type II odontoid fractures: Odontoid process prosthetic (Ti)

SURG Journal ◽  
2008 ◽  
Vol 1 (2) ◽  
pp. 49-56
Author(s):  
Marc Johnston ◽  
Shawn Ranieri ◽  
William De Wit
Keyword(s):  
Vertebral Body ◽  
Odontoid Process ◽  
Odontoid Fracture ◽  
Neurological Deficits ◽  
Type Ii ◽  
Sintered Titanium ◽  
Implant Fixation ◽  
Odontoid Fractures ◽  
Non Union ◽  
Novel Method

A novel method for treating type II odontoid fractures is presented. The use of a sintered titanium odontoid prosthetic could eliminate long healing times associated with external fixation methods, and the neurological deficits associated with non-union events in odontoid fracture treatment. Finite element experiments provide early indications that the axis vertebral body could accommodate a titanium odontoid prosthetic. Strain of 3.5 % and stresses of up to 10.5 MPa on the reamed opening of the axis vertebral body are considered as the local maximums. Conventional and emerging implant fixation and non-fouling techniques are also discussed.

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