Anterior Dens Screw Fixation for Traumatic C1-2 Lateral Subluxation With 3-Part Fractures of the C2 Axis (Dens, Lateral Mass, and Hangman Fractures): A Case Report

Background: Tubercular atlantoaxial, rotary dislocation warranting fixation (AARF) is an extremely rare event. Case Description: AARF was suspected in a 23-year-old female with painful torticollis. When diagnostic studies documented unilateral destruction of the left lateral mass of the atlas, she underwent removal of the lateral mass, reduction of the deformity, and C1-C2 fusion/reconstruction utilizing an iliac bone graft. Laboratory tests and the pathologic surveys were all consistent with the diagnosis of underlying tuberculosis. Conclusion: We present a case of tubercular atlantoaxial, rotary dislocation (AARF) in a patient who warranted C1-C2 decompression, reduction, and fusion.

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Transoral digital reduction of complete anterior odontoid dislocation followed by fiducial-based navigated transcondylar screw fixation: illustrative case

Journal of Neurosurgery: Case Lessons ◽

10.3171/case21576 ◽

2022 ◽

Vol 3 (3) ◽

Keyword(s):

Spinal Fusion ◽

Screw Fixation ◽

Treatment Options ◽

Pedicle Screws ◽

Craniocervical Junction ◽

Atlantoaxial Instability ◽

Illustrative Case ◽

Trauma Patients ◽

Lateral Mass ◽

Craniocervical Instability

BACKGROUND Posterior atlantoaxial dislocations (i.e., complete anterior odontoid dislocation) without C1 arch fractures are a rare hyperextension injury most often found in high-velocity trauma patients. Treatment options include either closed or open reduction and optional spinal fusion to address atlantoaxial instability due to ligamentous injury. OBSERVATIONS A 60-year-old male was struck while on his bicycle by a truck and sustained an odontoid dislocation without C1 arch fracture. Imaging findings additionally delineated a high suspicion for craniocervical instability. The patient had neurological issues due to both a head injury and ischemia secondary to an injured vertebral artery. He was stabilized and transferred to our facility for definitive neurosurgical care. LESSONS The patient underwent a successful transoral digital closed reduction and posterior occipital spinal fusion via a fiducial-based transcondylar, C1 lateral mass, C2 pedicle, and C3 lateral mass construct. This unique reduction technique has not been recorded in the literature before and avoided potential complications of overdistraction and the need for odontoidectomy. Furthermore, the use of bone fiducials for navigated screw fixation at the craniocervical junction is a novel technique and recommended particularly for placement of technically demanding transcondylar screws and C2 pedicle screws where pars anatomy is potentially unfavorable.

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Arthroscopy Assisted Percutaneous Reduction and Screw Fixation of a Displaced Intra-articular Glenoid Fracture - A Case Report -

Clinics in Shoulder and Elbow ◽

10.5397/cise.2010.13.1.127 ◽

2010 ◽

Vol 13 (1) ◽

pp. 127-131 ◽

Cited By ~ 2

Author(s):

Sang-Hun Ko ◽

Hyung-Min Jeon ◽

Seung-Myeong Shin

Keyword(s):

Case Report ◽

Screw Fixation ◽

Glenoid Fracture ◽

Percutaneous Reduction

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Subdural Hemorrhage after Scoliosis and Detethering of Cord Surgery

Case Reports in Medicine ◽

10.1155/2018/5061898 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3

Author(s):

Rohan Bhimani ◽

Fardeen Bhimani ◽

Preeti Singh

Keyword(s):

Case Report ◽

Idiopathic Scoliosis ◽

Intracranial Hypotension ◽

Rare Case ◽

Screw Fixation ◽

Conus Medullaris ◽

Csf Leak ◽

Subdural Hemorrhage ◽

Pedicular Screw ◽

Csf Leaks

Introduction. Intracranial hypotension may occur when CSF leaks from the subarachnoid space. Formation of intracranial, subdural, and subarachnoid hemorrhage has been observed after significant CSF leak as seen in lumbar puncture or ventricular shunt placement. However, very few cases, referring to these remote complications following spine surgery, have been described in literature. We present a case of a 10-year-old male child operated for idiopathic scoliosis with low-lying conus medullaris who postoperatively developed subdural hemorrhage. Case Report. A case of a 10-year-old male operated for idiopathic scoliosis with low-lying conus medullaris is presented. To correct this, detethering was done at the L3 level, laminectomy was done from L2 to L3 with pedicular screw fixation from T3 to L2, and bone grafting with right costoplasty was done from the 3rd to the 6th ribs. On the 5th day postoperatively, the patient developed convulsions and drowsiness and recovered subsequently by postoperative day 7. Conclusion. We report a rare case of an acute intracranial subdural hemorrhage caused by intracranial hypotension following scoliosis and detethering of cord surgery. This report highlights the potential morbidity associated with CSF leak occurring after this surgery.

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