scholarly journals Odontoid fracture that is not listed in the existing classifications A new subtype of odontoid fracture: case report

2016 ◽  
Vol 30 (1) ◽  
pp. 57-64 ◽  
Author(s):  
D. Adam ◽  
R. Cergan ◽  
D. Iftimie ◽  
Cristiana Moisescu
Keyword(s):  
Rare Case ◽  
Clinical Presentation ◽  
Treatment Strategies ◽  
Odontoid Process ◽  
Ground Level ◽  
Odontoid Fracture ◽  
Type Ii ◽  
Fracture Type ◽  
Cervical Trauma ◽  
The Right

Abstract Background: There is a significant variety of odontoid fracture classifications along with corresponding treatment strategies. There are though cases which cannot be framed within the existing classifications. Clinical presentation: We report the case of a 91 years old female patient who suffered a cervical trauma secondary to a ground level fall. The cervical CT scan revealed a particular type of odontoid fracture, unframeable within existing classifications. The fracture line was at the base of the odontoid process and continued in an oblique trajectory through the right pedicle of the axis. As treatment strategy, we opted for external immobilization in a Minerva jacket and, after 3 months, the patient is symptom free, with partial bone fusion. Conclusion: We named this rare case of odontoid fracture type II B for which external immobilization seems sufficient.

Cervical 1-2 Posterior Instrumented Fusion Utilizing Computer-Assisted Navigation With Harvest of Rib Strut Autograft: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Timothy J Yee ◽  
Michael J Strong ◽  
Matthew S Willsey ◽  
Mark E Oppenlander
Keyword(s):  
Surface Area ◽  
Odontoid Process ◽  
Odontoid Fracture ◽  
Patient Specific ◽  
Computer Assisted ◽  
Type Ii ◽  
Instrumented Fusion ◽  
Assisted Navigation ◽  
Patient Consent ◽  
Posterior Instrumented Fusion

Abstract Nonunion of a type II odontoid fracture after the placement of an anterior odontoid screw can occur despite careful patient selection. Countervailing factors to successful fusion include the vascular watershed zone between the odontoid process and body of C2 as well as the relatively low surface area available for fusion. Patient-specific factors include osteoporosis, advanced age, and poor fracture fragment apposition. Cervical 1-2 posterior instrumented fusion is indicated for symptomatic nonunion. The technique leverages the larger posterolateral surface area for fusion and does not rely on bony growth in a watershed zone. Although loss of up to half of cervical rotation is expected after C1-2 arthrodesis, this may be better tolerated in the elderly, who may have lower physical demands than younger patients. In this video, we discuss the case of a 75-yr-old woman presenting with intractable mechanical cervicalgia 7 mo after sustaining a type II odontoid fracture and undergoing anterior odontoid screw placement at an outside institution. Cervical radiography and computed tomography exhibited haloing around the screw and nonunion across the fracture. We demonstrate C1-2 posterior instrumented fusion with Goel-Harms technique (C1 lateral mass and C2 pedicle screws), utilizing computer-assisted navigation, and modified Sonntag technique with rib strut autograft.  Posterior C1-2-instrumented fusion with rib strut autograft is an essential technique in the spine surgeon's armamentarium for the management of C1-2 instability, which can be a sequela of type II dens fracture. Detailed video demonstration has not been published to date.  Appropriate patient consent was obtained.

scholarly journals [A rare case of sepsis from Citrobacter koseri in adults]

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Matteo Pistoia ◽  
Mariella Ciola ◽  
Girolamo Sala ◽  
Fabrizio Foieni ◽  
Andrea Agostinelli ◽  
...  
Keyword(s):  
Orthopedic Surgery ◽  
Type Ii Diabetes ◽  
Rare Case ◽  
Clinical History ◽  
Needle Aspiration ◽  
Type Ii Diabetes Mellitus ◽  
Type Ii ◽  
Left Wrist ◽  
The Right ◽  
Physical Features

We describe the case of a 53-year-old man, recently diagnosed with decompensated type II diabetes mellitus, admitted to our Department for fever, asthenia, and detection of multiple lung abscesses and pulmonary embolism at chest tomography.His clinical history revealed just a recent orthopedic surgery of osteosynthesis on the left wrist with normal clinical and instrumental post-surgical evolution. Empirical antibiotic therapy with piperacillin/tazobactam and clindamycin was initiated. During hospital stay, swelling and functional impotence in the right knee occurred. They were investigated by arthrocentesis and magnetic resonance, and diagnosed as septic arthritis.Blood culture performed at admission tested positive for Citrobacter koseri on several samples where meropenem was added according to antibiogram. On the other hand, the cultures of bronchoaspirate, pulmonary fine needle aspiration, and arthrocentesis were negative.Antibiotic therapy was administered up to two weeks after discharge and radiological and physical features progressively improved.

scholarly journals A Rare Case of Chlamydia Trachomatis Associated Fitz-Hugh-Curtis Syndrome Masquerading Acute Cholecystitis

2020 ◽  
pp. 1-3
Author(s):  
Richmond Ronald Gomes ◽  
Keyword(s):  
Chlamydia Trachomatis ◽  
Inflammatory Disease ◽  
Rare Case ◽  
Clinical Presentation ◽  
Rare Complication ◽  
Starting Point ◽  
The Right ◽  
Cause Of Pain ◽  
Enhancement Characteristic ◽  
Fitz Hugh Curtis Syndrome

Fitz-Hugh–Curtis syndrome (FHCS) isa rare complication of pelvic inflammatory disease (PID) characterized by inflammation of the liver capsule (perihepatitis) following the spread of a pelvic starting point infection leading to the creation of adhesions. The most commonly involved germ is Chlamydia trachomatis. The condition is named after the two physicians, Thomas Fitz-Hugh, Jr and Arthur Hale Curtis who first reported this condition in 1934 and 1930 respectively. The clinical presentation can be misleading and simulate cholecystitis or other cause of pain in the right hypochondrium. In imaging, it results in a contrast enhancement characteristic of the hepatic capsule at portal time.

scholarly journals Chronic hypertrophic malunion of C2 Fracture causing cervical quadriparesis; Case report and focused literature review

2019 ◽  
Vol 10 ◽  
pp. 107 ◽  
Author(s):  
Sanaullah Khan Bashir ◽  
Syeda Maheen Batool ◽  
Gohar Javed
Keyword(s):  
Cervical Myelopathy ◽  
Odontoid Fracture ◽  
Type Ii ◽  
Case Description ◽  
Anterior Decompression ◽  
Cervical Trauma ◽  
Spinal Stabilization ◽  
Odontoid Fractures ◽  
Unstable Type ◽  
C2 Fracture

Background: Pseudarthrosis of Type II C2 odontoid fractures typically leads to displacement and subluxation resulting in canal compression/cervical myelopathy. Case Description: Here, we present a 43-year-old male who sustained cervical trauma 28 years ago. He now presented with an acute 10-day onset of quadriparesis attributed to a chronic malunion of an unstable type II odontoid fracture. He successfully underwent a circumferential decompression and fusion (e.g., warranting a trans-oral odontoidectomy followed by C1-C3 posterior fusion). Conclusion: Progressive cervical myelopathy attributed to a chronic malunion of a type II odontoid fracture may require circumferential decompression/stabilization (e.g., an anterior decompression with osteophyte resection and posterior C1-C3 spinal stabilization).

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.

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.

scholarly journals Relationship between odontoid fracture angle and cervical sagittal balance

2021 ◽  
Vol 12 ◽  
pp. 157
Author(s):  
Colin Gold ◽  
Scott Seaman ◽  
Satoshi Yamaguchi
Keyword(s):  
Sagittal Balance ◽  
Motor Vehicle ◽  
Odontoid Process ◽  
Ground Level ◽  
Odontoid Fracture ◽  
X Rays ◽  
Posterior Angle ◽  
Sagittal Vertical Axis ◽  
Fracture Angle ◽  
Cervical Sagittal Balance

Background: Fractures can occur in various locations within the odontoid process with differing orientations. However, little is known about what factors contribute to the anterior versus posterior angles/orientation of these fractures. Methods: We evaluated 74 patients with odontoid fractures (2013–2018) from a single-institution. Patients’ fracture angles/orientations were measured on computed tomography studies, and were grouped into oblique posterior (OP) or oblique anterior (OA) groups. We also took into account cervical sagittal balance utilizing upright x-rays. Other variables studied included patients’ ages, sagittal balance measurements, and the mechanisms of injury. Results: Fracture angles were significantly steeper in the OP group. OP fractures had larger C2-C7 sagittal vertical axis, occiput-C2 angles, and occiput-C7 angles versus anteriorly oriented fractures. In our linear regression model, advanced age and large occiput-C2 angles were predictive of the odontoid fracture angle. Patients who sustained ground-level falls also had significantly steeper fracture angles versus those involved in motor vehicle accidents. Conclusion: The odontoid tends to fracture at a steep, posterior angle in elderly patients who demonstrate a large positive sagittal balance when the head is extended following a ground-level falls.

scholarly journals A Rare Case of Posttraumatic Bilateral BPPV Presentation

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Sinisa Maslovara ◽  
Andro Kosec ◽  
Ivana Pajic Matic ◽  
Anamarija Sestak
Keyword(s):  
Laboratory Tests ◽  
Rare Case ◽  
Benign Paroxysmal Positional Vertigo ◽  
Clinical Presentation ◽  
Lateral Canal ◽  
Positional Vertigo ◽  
Appropriate Treatment ◽  
Precise Diagnosis ◽  
The Right ◽  
Paroxysmal Positional Vertigo

A rare case of a 38-year-old female patient who developed benign paroxysmal positional vertigo (BPPV) three weeks after head trauma is presented. The disease manifested bilaterally, which is not uncommon posttraumatically, but in this case, it manifested itself as canalithiasis of the posterior canal on both sides and cupulolithiasis of the right lateral canal, which to our knowledge is a unique and, until now, unpublished case. The aim of this review is to point out the fact that, in such a complex multicanal and bilateral clinical presentation of BPPV, it is not sufficient to perform only positioning but also additional laboratory tests. With a good knowledge of the etiopathogenesis, pathophysiology and clinical forms of BPPV, we can, in most cases, make an accurate and precise diagnosis of the disease and carry out appropriate treatment.

scholarly journals Management of Type – II Odontoid Process Fracture by Anterior Odontoid Screw Fixation (AOSF) in Young Adults: Case Series

2020 ◽  
Vol 24 (2) ◽  
Author(s):  
SHAMS RAZA BROHI ◽  
MUZAMIL DILBAR ◽  
FAHMIDA ARAB MALLAH ◽  
SUNNY THAPA
Keyword(s):  
Screw Fixation ◽  
Odontoid Process ◽  
Case Series ◽  
Odontoid Fracture ◽  
Treatment Modalities ◽  
Unstable Fracture ◽  
Type Ii ◽  
Union Rate ◽  
Lag Screw ◽  
Odontoid Process Fracture

odontoid fracture AOSF with lag screw is the reference technique in unstable fracture. Various other treatment modalities have been described in the literature; however author finds the ASOF technique to be reasonable with less intraoperative and post-operative complications. Moreover the rate of bony fusion is also high and post-operative mobilization in case of ASOF. Material and Methods:  This is prospective observational case series. Two cases of odontoid fractures (type II) are reported. Results and Conclusion:  Our cases illustrated that odontoid fracture type II can successfully be managed with AOSF with good post-operative outcome. Union rate of this fracture is high with lag screw fixation (AOSF technique). Nevertheless, due to a limited number of cases author would also like to add that outcome could be better assessed in a larger group of study.

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