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

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.

Download Full-text

Chronic Neck Pain Associated with an Old Odontoid Fracture: A Rare Presentation

Case Reports in Emergency Medicine ◽

10.1155/2013/372723 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4

Author(s):

Mauricio Avila-Guerra

Keyword(s):

Cervical Spine ◽

Neurological Deficit ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Odontoid Fracture ◽

Motor Vehicles ◽

Rare Presentation ◽

Cervical Spine Injuries ◽

Wide Range ◽

Spine Injuries

Cervical spine injuries represent a minority of injury cases in motor vehicles accidents but are a real threat to a patient’s life. In the wide range of cervical spine injuries, odontoid (dens) fractures represent the most common findings. These fractures are more usually found in the elderly population due to the changes associated with age. Neurological deficit is not frequently found in these injuries. The following is a case presentation of a chronic odontoid fracture with neurological deficit in a young man that was discovered 23 years after he sustained a motor vehicle accident.

Download Full-text

The Treatment of Concomitant Odontoid Fracture and Lower Cervical Spine Injuries

Spine ◽

10.1097/brs.0b013e31817c4ecf ◽

2008 ◽

Vol 33 (19) ◽

pp. E693-E698 ◽

Cited By ~ 3

Author(s):

Fangcai Li ◽

Qixin Chen ◽

Kan Xu

Keyword(s):

Cervical Spine ◽

Odontoid Fracture ◽

Lower Cervical Spine ◽

Cervical Spine Injuries ◽

Spine Injuries

Download Full-text

UPPER CERVICAL SPINE INJURIES: DIAGNOSTICS, CLASSIFICATIONS AND TREATMENT PECULIARITIES

Hirurgiâ pozvonočnika ◽

10.14531/ss2005.1.25-44 ◽

2005 ◽

pp. 025-044

Author(s):

Edvard Aleksandrovich Ramikh

Keyword(s):

Cervical Spine ◽

Odontoid Process ◽

Upper Cervical Spine ◽

Treatment Technique ◽

Cervical Spine Injuries ◽

Spine Injuries ◽

Upper Cervical ◽

Methods Of Treatment ◽

Traumatic Spondylolisthesis ◽

Selection Of

Comprehensive diagnostics, accepted classifications, and selection of pathogenetic methods of treatment (including surgery) for axis injuries, odontoid process fractures, axis traumatic spondylolisthesis and hangman’s fractures are discussed in the paper. The presented data prove the necessity and possibility of early exhaustive diagnosing to differentiate the type of a craniocervical disorder and to provide a timely choice of pathogenetic treatment technique, especially of a surgical one.

Download Full-text

Biomechanical Aspects of Odontoid Fracture Etiology: A Finite Element Investigation

10.1115/imece1999-0360 ◽

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.

Download Full-text

Detection of Cervical Spine Injuries in Alert, Asymptomatic Geriatric Blunt Trauma Patients: Who Benefits from Radiologic Imaging?

The American Surgeon ◽

10.1177/000313480607200903 ◽

2006 ◽

Vol 72 (9) ◽

pp. 773-777 ◽

Cited By ~ 1

Author(s):

Adrian W. Ong ◽

Aurelio Rodriguez ◽

Robert Kelly ◽

Vicente Cortes ◽

Jack Protetch ◽

...

Keyword(s):

Computed Tomography ◽

Cervical Spine ◽

Blunt Trauma ◽

Cervical Spine Injury ◽

Motor Vehicle ◽

Spine Injury ◽

Trauma Patients ◽

Cervical Spine Injuries ◽

Spine Injuries ◽

Anatomic Locations

There are differing recommendations in the literature regarding cervical spine imaging in alert, asymptomatic geriatric patients. Previous studies also have not used computed tomography routinely. Given that cervical radiographs may miss up to 60 per cent of fractures, the incidence of cervical spine injuries in this population and its implications for clinical management are unclear. We conducted a retrospective study of blunt trauma patients 65 years and older who were alert, asymptomatic, hemodynamically stable, and had normal neurologic examinations. For inclusion, patients were required to have undergone computed tomography and plain radiographs. The presence and anatomic location of potentially distracting injuries or pain were recorded. Two hundred seventy-four patients were included, with a mean age of 76 ± 10 years. The main mechanisms of injury were falls (51%) and motor vehicle crashes (41%). Nine of 274 (3%) patients had cervical spine injuries. The presence of potentially distracting injuries above the clavicles was associated with cervical injury when compared with patients with distracting injuries in other anatomic locations or no distracting injuries (8/115 vs 1/159, P = 0.03). There was no association of cervical spine injury with age greater or less than 75 years or with mechanism of injury. The overall incidence of cervical spine injury in the alert, asymptomatic geriatric population is low. The risk is increased with a potentially distracting injury above the clavicles. Patients with distracting injuries in other anatomic locations or no distracting injuries may not need routine cervical imaging.

Download Full-text

Management of cervical spine injuries in young children: lessons learned

Journal of Neurosurgery Pediatrics ◽

10.3171/2009.2.peds08362 ◽

2009 ◽

Vol 4 (1) ◽

pp. 64-73 ◽

Cited By ~ 9

Author(s):

Jodi L. Smith ◽

Laurie L. Ackerman

Keyword(s):

Cervical Spine ◽

Young Children ◽

Motor Vehicle ◽

Public Awareness ◽

Lessons Learned ◽

Infants And Children ◽

Cervical Spine Injuries ◽

Spine Injuries ◽

Car Safety ◽

Safety Seat

Previous studies have shown that the correct use of car safety seats can protect infants and children from vehicular injury. Although child passenger devices are increasingly used in the US, motor vehicle crashes continue to be the leading cause of death and acquired disability in infants and children younger than 14 years of age. These events are likely related, at least in part, to the high percentage of children who are unrestrained or improperly restrained. The authors present 2 cases of severe cervical spine trauma in young children restrained in car safety seats during a motor vehicle crash: 1) a previously healthy 14-month-old girl who was improperly restrained in a forward-facing booster seat secured to the vehicle by a lap belt, and 2) a previously healthy 30-month-old girl who was a rear seat passenger restrained in a car safety seat. This study points out the unique challenges encountered in treating cervical spine injuries in infants and young children, as well as the lessons learned, and emphasizes the significance of continuing efforts to increase family and public awareness regarding the importance of appropriate child safety seat selection and use.

Download Full-text

Effect of age on cervical spine injuries in children after motor vehicle collisions: effectiveness of restraint devices

Journal of Pediatric Surgery ◽

10.1016/j.jpedsurg.2003.11.046 ◽

2004 ◽

Vol 39 (3) ◽

pp. 483-486 ◽

Cited By ~ 24

Author(s):

Brian S Zuckerbraun ◽

Katie Morrison ◽

Barbara Gaines ◽

Henri R Ford ◽

David J Hackam

Keyword(s):

Cervical Spine ◽

Motor Vehicle ◽

Motor Vehicle Collisions ◽

Vehicle Collisions ◽

Cervical Spine Injuries ◽

Spine Injuries ◽

Effect Of Age

Download Full-text

Cervical spine injuries associated with lateral mass and facet joint fractures

The Spine Journal ◽

10.1016/s1529-9430(02)00383-2 ◽

2002 ◽

Vol 2 (5) ◽

pp. 120-121

Author(s):

Yoshihisa Kotani ◽

Kuniyoshi Abumi ◽

Manabu Ito ◽

Akio Minami

Keyword(s):

Cervical Spine ◽

Facet Joint ◽

Lateral Mass ◽

Cervical Spine Injuries ◽

Spine Injuries ◽

Joint Fractures

Download Full-text

Pediatric subaxial cervical spine injuries: origins, management, and outcome in 51 patients

Neurosurgical FOCUS ◽

10.3171/foc.2006.20.2.2 ◽

2006 ◽

Vol 20 (2) ◽

pp. 1-7 ◽

Cited By ~ 40

Author(s):

Seref Dogan ◽

Sam Safavi-Abbasi ◽

Nicholas Theodore ◽

Eric Horn ◽

Harold L. Rekate ◽

...

Keyword(s):

Cervical Spine ◽

Spinal Cord Injuries ◽

Motor Vehicle ◽

Fracture Dislocation ◽

Cervical Spine Injuries ◽

Factors Affecting ◽

Vehicle Accidents ◽

Subaxial Cervical Spine ◽

Cervical Orthosis ◽

Spine Injuries

Object In this study the authors evaluated the mechanisms and patterns of injury and the factors affecting management and outcome of pediatric subaxial cervical spine injuries (C3–7). Methods Fifty-one pediatric patients (38 boys and 13 girls; mean age 12.4 years, range 10 months–16 years) with subaxial cervical spine injuries were reviewed retrospectively. Motor vehicle accidents (MVAs) were the most common cause of injury. Overall, 12% presented with a dislocation, 63% with a fracture, 19% with a fracture–dislocation, and 6% with a ligamentous injury. The most frequently injured level was C6–7 (33%); C3–4 (6%) was least frequently involved. Sixty-four percent of patients were neurologically intact, 16% had incomplete spinal cord injuries (SCIs), 14% had complete SCIs, and three patients (6%) died after admission and before assessment. Treatment was conservative in 64%: seven (13%) wore a halo vest and 26 (51%) wore a rigid cervical orthosis. Surgery was performed in the other 18 patients (36%), with the breakdown as follows: 15 (30%) underwent an anterior approach, two (4%) had posterior approaches, and one (2%) had a combined approach. Postoperatively, four patients (8%) who had a neurological deficit improved. The overall mortality rate was 8%; all deaths were related to MVAs. There were no surgery-related deaths or complications. Conclusions Subaxial cervical spine injuries are common in children 9 to 16 years of age, and occur principally between C-5 and C-7. Multilevel injury is more common in children 8 years of age and older than in younger children and infants. Most patients with subaxial cervical spine injuries can be treated conservatively. Both anterior and posterior approaches are safe and effective.

Download Full-text