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

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.

2020 ◽  
Vol 17 (2) ◽  
pp. 73-76
Author(s):  
Dinuj Shrestha ◽  
Pratyush Shrestha

Odontoid fracture comprises approximately 20% of all cervical spine fractures. Among them type II fracture accounts for about 65-74%. Presently, direct anterior screw fixation is considered to provide successful outcome with fracture healing of 80% and also preserve C1/C2 rotation movement with benefit of early mobilization and rapid return to normal life style. Recent fracture(<6months) have high fusion rate of 90% with this approach and for remote fracture(≥18months) it reduces to 25%. Here we present a case report of 18 years old female with type II odontoid fracture and underwent anterior transcervical lag screw fixation under C-arm guidance.


2021 ◽  
Author(s):  
Timothy J Yee ◽  
Michael J Strong ◽  
Matthew S Willsey ◽  
Mark E Oppenlander

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.


2020 ◽  
Vol 2020 (8) ◽  
Author(s):  
Preci Hamilton ◽  
Peyton Lawrence ◽  
Christian Valentin Eisenring

Abstract Odontoid fractures constitute the commonest cervical spinal fracture in the elderly. There are varied management approaches with paucity of robust evidence to guide decision-making. We review the case of a 92-years-old man with traumatic Grauer type II B odontoid fracture treated with anterior cannulated screw fixation. Postoperatively, he was noted to have dysphagia due to a zenker’s diverticulum. Further history revealed repair of a zenker’s diverticulum ~40 years prior. Cervical spine images and video fluoroscopy demonstrated a recurrent zenker’s diverticulum. After re-excision of the recurrent zenker’s diverticulum his dysphagia resolved. This unique case describes dysphagia due to recurrent zenker’s diverticulum presenting after anterior cannulated screw fixation for type II B odontoid fracture. The dysphagia was diagnosed and treated in close collaboration with speech and language therapists and otorhinolaryngologist. This underscores the importance of holistic approach to the elderly patient with odontoid fractures.


2021 ◽  
Vol 11 (9) ◽  
Author(s):  
Matthew A. Prevost ◽  
John G. DeVine ◽  
Uzondu F. Agochukwu ◽  
Jacob C. Rumley

Introduction:Odontoid fractures are one of the most common injuries to the cervical spine. Type II odontoid fracture treatment varies depending on age, co-morbidities, and fracture morphology. Treatment ranges from cervical orthosis to surgical intervention. Currently fractures with high non-union rates are considered for operative management which includes displacement of >6 mm, increasing age (>40-60 years), fracture gap >1 mm, delay in treatment >4 days, posterior re-displacement >2 mm, increased angulation, and history of smoking. While re-displacement of >2 mm has been associated with increased risk of non-union;, to the best of our knowledge, no studies have looked at the risk factors for re-displacement. Case Report:We present two 26-year-old male patients who were found to have minimally displaced type II odontoid fractures initially treated in a cervical collar. These two patients were subsequently found to have displaced their odontoid fracture after having a documented seizure. Conclusion:We suggest that a history of seizures be considered a risk factor for re-displacement of non-displaced type II odontoid fractures. Keywords:Operative indications odontoid case report, Type II odontoid fracture, Displacement, Seizure, Odontoid fracture displacement, Nondisplaced type ? odontoid fracture.


1999 ◽  
Author(s):  
Christian M. Puttlitz ◽  
Vijay K. Goel ◽  
Charles R. Clark

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.


2021 ◽  
pp. 45-47
Author(s):  
B.D. B.S. Naik ◽  
M.V. Vijayasekhar ◽  
P Prahaladhu ◽  
K Satyavaraprasad ◽  
Nikhil Tadwalkar

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.


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