Sami Ibrahim AlEissa, Ali Abdullah Alhandi, Ahad Abdullah Bugis, Raghad Khalid Alsalamah, Abdulellah Alsheddi, Abdulaziz Khalid Almubarak, Suhail Saad AlAssiri, Faisal MohammedSaleh Konbaz
Background: Cervical spine injury is the most common vertebral injury after major trauma, 20% of all cervical fractures happen to be odontoid fractures. In young adults, odontoid fracture usually happens as a result of high-energy trauma after a motor vehicle accident (MVA). MVA in Riyadh represents 38.4% of all trauma cases, in which the head-and-neck are the most injured body parts. This research aims to provide information about the incidence of odontoid process fracture post-MVA in Riyadh, Saudi Arabia...
April 2020: Journal of Craniovertebral Junction and Spine
Preci Hamilton, Peyton Lawrence, Christian Valentin Eisenring
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...
August 2020: Journal of Surgical Case Reports
Pravin Salunke, Parth Jani, Sushanta K Sahoo, Chandrashekhar Gendle
BACKGROUND: Odontoid synchondral fractures in very young children with displacement/angulation are highly unstable and require surgical intervention. Soft and small bones with poor pull-out strengths make instrumentation and manipulation difficult. CASE REPORT: We report an 18-month-old child with such a fracture where minimal traction made C1-2 dysjunction apparent with neurological worsening. The C1-2 facets were fixed with a short plate and facetal screws. The child had a good outcome...
August 11, 2020: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Alisa Zhukhovitskaya, Arya N Shamie, Dinesh Chhetri
A 77-year-old male underwent open reduction and internal fixation with placement of odontoid screws after sustaining C1 arch and odontoid fractures in a fall 14 months prior to presentation to the laryngology clinic for combined surgery with orthopedics. Serial imaging after the initial surgery demonstrated loosening of a screw and its entry into the pharyngeal lumen. The patient reported odynophagia, dysphagia, and dysphonia. He reported taking small bites and using liquid assist, vocal fatigue, and difficulty with pitch control...
August 5, 2020: Laryngoscope
Kelechi Eseonu, Uche Oduoza, Bahram Fakouri, Panos Liantis
No abstract text is available yet for this article.
July 25, 2020: Injury
Kaissar Farah, Mikael Meyer, Solene Prost, Henry Dufour, Benjamin Blondel, Stephane Fuentes
BACKGROUND: Accurate screw placement remains very challenging especially in the upper cervical spine. OBJECTIVE: To present our first experience of a percutaneous posterior C1-C2 fixation for a traumatic fracture. METHODS: This is a case report of a non-neurological patient, harboring a type II odontoid fracture. She underwent a posterior percutaneous fixation using Cirq® Robotic Assistance coupled to the AIRO® intraoperative computed tomography (iCT)-scan and BrainLab® navigation system (all by BrainLab AG)...
July 25, 2020: Operative Neurosurgery (Hagerstown, Md.)
Julien Dimitriou, Marta Garvayo, Juan Barges Coll
BACKGROUND: Transarticular C1-C2 screw fixation, first described by Magerl, is a widely accepted used technique for C1-C2 instability with a good biomechanical stability and fusion rate. METHOD: We present a 69-year-old woman, who was diagnosed with a C2 Odontoid fracture type III and primarily treated with conservative treatment and collar. During first 2 weeks of follow-up, the patient developed cervical pain associated with C1-C2 instability. A minimally invasive posterior C1-C2 transarticular screw instrumentation with a percutaneus approach was performed...
September 2020: Acta Neurochirurgica
Paul M Arnold, Mark D Whiting
No abstract text is available yet for this article.
July 20, 2020: Neurosurgery
Nitesh Gahlot
CASE: A 47-year-old man presented with traumatic anterior atlantoaxial subluxation (type III) associated with type III odontoid fracture with no neurological deficit. He was managed surgically with posterior reduction and C1-C2 fixation and fusion. The association of anterior atlantoaxial rotatory subluxation (Fielding type III) with odontoid fracture (Anderson and D'Alonzo type III) is rare with only 7 reported cases in recent literature. CONCLUSIONS: This report adds important information regarding the management and presentation of such an injury and also describes a serious complication associated with type III odontoid fractures, which was managed conservatively...
April 2020: JBJS Case Connector
Vladimir Klimov, Murodzhon Kosimshoev, Aleksey Evsyukov, Vitaly Stepanenko, Jamil Rzaev
We report a case of the atlantoaxial (C1-2) deformity secondary to a neglected C2 odontoid fracture that was successfully treated with 3-stage operation performed in one session.
July 3, 2020: British Journal of Neurosurgery
Suzanne McIlroy, Jordan Lam, Muhammad Faheem Khan, Asfand Baig Mirza, Jerry Ajayi Philip, Gordan Grahovac, David Bell
BACKGROUND: Type II odontoid fractures are a common cervical fracture in older people. Lower osseous-union rates are reported in those treated conservatively compared to surgically; however, the clinical relevance of a nonunion is unknown. OBJECTIVE: To compare pain, disability, and quality of life in older people following conservative management of type II odontoid fractures demonstrating osseous-union and nonunion. METHODS: Electronic records were searched from 2008 to 2018 for adults ≥65 yr with type II odontoid fracture, managed in a semi-rigid collar...
June 22, 2020: Neurosurgery
Ivan Lvov, Andrey Grin, Aleksandr Talypov, Ivan Godkov, Anton Kordonskiy, Ulugbek Khushnazarov, Vladimir Smirnov, Vladimir Krylov
PURPOSE: The primary goal of this study was to conduct a systematic review and meta-analysis of articles focused on odontoid screw fixation (OSF) and screw-related complications or non-union rates. METHODS: We conducted a systematic review of the PubMed and Crossref databases between January 1982 and December 2019. Inclusion criteria comprised detailed descriptions of the surgical technique and screw-related complications (screw cut-out, loosening, breakage, malposition) or fusion rates...
June 15, 2020: European Spine Journal
Narendra Reddy Medagam, Charanjit Singh Dhillon, Chetan Shashikant Pophale, NilayPrafulsinh Chhasatia, Anandkumar Khatavi
Introduction: Cervical spine injuries in the children are unusual, and an incidence rate of 1.5-3% of all the spinal fractures has been reported. The cartilaginous end plate between the dens and the body of the axis usually ossifies at the age of 5-7 years. This anatomical characteristic has been attributed to odontoid synchondrosis fractures in young children. However, odontoid process fractures are rare in children and only few cases have been reported in literature. Case Report: We report a case of a displaced odontoid synchondrosis fracture in a 2-year-old girl with anterior subluxation of C1 over C2 vertebra...
2020: Journal of Orthopaedic Case Reports
Ahmed Taha Elsayed Shaaban, Ahmed Doomi, Sirajeddin Belkheir
Background: Type 2 odontoid fractures are the most common type of fracture of the axis. In rare cases, nonunion of a type 2 odontoid fracture can be hypertrophic resulting in myelopathy due to cervical cord compression. Case Description: A 48-year-old male presented with hypertrophic nonunion of a chronic type 2 odontoid fracture resulting in cord compression/myelopathy. This was adequately treated utilizing a C1 decompression and C1-3 instrumented fusion; no anterior procedure was necessary...
2020: Surgical Neurology International
Ahmad Tarawneh, Syed Taqvi, Khalid Salem, Opinder Sahota
BACKGROUND: cervical spine fractures are particularly prevalent in older people and commonly occur following a fall from standing height or less. Atlanto-axial complex (AAC) and, particularly, odontoid process (OP) fractures are the most prevalent injuries. OBJECTIVE: to investigate the incidence and characteristics of cervical spine fractures in older patients presenting to a regional spine centre. METHODS: a retrospective review of the clinical records and imaging of all patients aged 70 years and over presenting to a regional spinal unit with a cervical injury over a 5-year period was performed...
June 10, 2020: Age and Ageing
Jan-Uwe Müller, Jonas Müller, Sascha Marx, Marc Matthes, Stephan Nowak, Henry Werner Siegfried Schroeder, Dirk Thomas Pillich
BACKGROUND: Lag screw osteosynthesis in odontoid fractures shows a high rate of pseudarthrosis. Biomechanical properties may play a role with insufficient fragment compression or unnoticed screw stripping. A biomechanical comparison of different constructed lag-screws was carried out and the biomechanical properties determined. METHODS: Two identical compression screws with different pilot holes (1.25 and 2.5 mm), a double-threaded screw and one sleeve-nut-screw were tested on artificial bone (Sawbone, densities 10-30pcf)...
May 25, 2020: Clinical Biomechanics
Racheal Peterson, Edward Burkhardt, Anthony Sin
Traumatic atlantoaxial dislocation without associated odontoid fracture or neurological deficit is a rare occurrence. We present the case of a 39-year-old male pedestrian struck by a vehicle who suffered a traumatic grade 4 retrolisthesis of C1-C2. The closed reduction was successful and the patient underwent posterior occipito-cervical fusion. He retained good neurological status throughout the hospital stay and was discharged to a rehabilitation facility with full strength.
May 16, 2020: World Neurosurgery
Oliver Gembruch, Yahya Ahmadipour, Elias Lemonas, Oliver Müller
Background: Anterior transarticular screw fixation (ATSF) of C1/C2 can be used for the treatment of unstable dens fractures. Here, we evaluated the feasibility of an anterior C1/C2 fixation in elderly patients with unstable dens fractures. Furthermore, we tried to analyze safe entry zones for ATSF surgery. Methods: A consecutive cohort of 13 patients with unstable dens fractures were treated with ATSF of C1/C2 between January 2015 and October 2016. If necessary, an additional screw was placed into the odontoid process...
April 2020: International Journal of Spine Surgery
Gerard Mayà-Casalprim, Jose Ortiz, Ana Tercero, David Reyes, Álex Iranzo, Joan Santamaria, Xavier Bosch, Carles Gaig
Background: Cardiorespiratory arrest (CA) secondary to traumatic cervical spinal cord injury can occur in minor accidents with low-impact trauma and may be overlooked as the cause of CA in patients admitted in the coronary care unit. Case summary: We present two patients admitted to the coronary care unit because of suspected CA of cardiac origin. Both patients were found in CA with asystole, one after collapsing in a shopping mall and falling down a few steps and the other in the street next to his bicycle...
April 2020: European Heart Journal. Case Reports
Chuang Liu, Allieu Kamara, Yunhui Yan
BACKGROUND: The biomechanics of C1 posterior arch screw and C2 vertebral lamina screw techniques has not been well studied, and the biomechanical performance of the constructs cannot be explained only by cadaver testing. METHODS: From computed tomography images, a nonlinear intact three-dimensional C1-2 finite element model was developed and validated. And on this basis, models for the odontoid fractures and the three posterior internal fixation techniques were developed...
April 17, 2020: Journal of Orthopaedic Surgery and Research
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