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Odontoid fracture

Mueez Waqar, Dmitri Van-Popta, Damiano G Barone, Zaid Sarsam
INTRODUCTION: The aim of this systematic review was to compare the halo and hard collar in the management of adult odontoid fractures. METHODS: Systematic and independent searches on MEDLINE (PubMed) and the Cochrane database. INCLUSION CRITERIA: (1) clinical outcomes, (2) in adults (≥18), (3) with odontoid fractures, (4) immobilised using a halo or hard collar, (5) in multiple (>5) patients. Treatment failure rates were calculated as the proportion requiring operative intervention...
October 15, 2016: World Neurosurgery
Eleftherios Archavlis, Lucas Serrano, Eike Schwandt, Amr Nimer, Moisés Felipe Molina-Fuentes, Tamim Rahim, Maximilian Ackermann, Angelika Gutenberg, Sven Rainer Kantelhardt, Alf Giese
OBJECTIVE The goal of this study was to demonstrate the clinical and technical nuances of a minimally invasive, dorsolateral, tubular approach for partial odontoidectomy, autologous bone augmentation, and temporary C1-2 fixation to treat dens pseudarthrosis. METHODS A cadaveric feasibility study, a 3D virtual reality reconstruction study, and the subsequent application of this approach in 2 clinical cases are reported. Eight procedures were completed in 4 human cadavers. A minimally invasive, dorsolateral, tubular approach for odontoidectomy was performed with the aid of a tubular retraction system, using a posterolateral incision and an oblique approach angle...
September 30, 2016: Journal of Neurosurgery. Spine
Megan E Gornet, Michael P Kelly
Fractures of the second cervical vertebra (C2, axis) are common in adult spine surgery. Those fractures occurring in younger adult patients are often associated with high-energy mechanism trauma, resulting in a "Hangman's Fracture." Management of these fractures is often successful with nonoperative means, though surgery may be needed in those fractures with greater displacement and injury to the C2-C3 disc. Older patients are more likely to sustain fractures of the odontoid process. The evidence supporting surgical management of these fractures is evolving, as there may be a mortality benefit to surgery...
September 29, 2016: Current Reviews in Musculoskeletal Medicine
Ufuk Demirci
No abstract text is available yet for this article.
September 23, 2016: Turkish Journal of Haematology: Official Journal of Turkish Society of Haematology
Deng-Wei He, Wen-Jun Huang, Xiao-Yong Sheng, Li-Jun Wu, Shun-Wu Fan
A rare case of atlantoaxial lateral mass joint interlocking secondary to traumatic posterolateral C1,2 complete dislocation associated with type II odontoid fracture is herein reported and the impact of atlantoaxial joint interlocking on fracture reduction discussed. A 72-year-old man presented with traumatic atlantoaxial lateral mass joint interlocking without spinal cord signal change, the diagnosis being confirmed by radiography and 3-D reconstruction digital anatomy. Posterior internal fixation was performed after failure to achieve closed reduction by skull traction...
August 2016: Orthopaedic Surgery
Wei Tian, Han Wang, Ya-Jun Liu
Anterior odontoid screw fixation has been proved to be effective but technically challenging because the difficult approach is associated with high risks of screw malposition and damage to surrounding vital structures. Navigation techniques are therefore increasingly being used to improve safety and accuracy. However, no robot-assisted odontoid screw fixation has yet been reported. We here report a 61-year-old woman with a type II dens fracture on whom anterior odontoid screw fixation was performed under the guidance of a newly developed robotic system (TiRobot, co-designed by Beijing Jishuitan Hospital and TINAVI Medical Technologies)...
August 2016: Orthopaedic Surgery
Mauro Dobran, Davide Nasi, Domenico Paolo Esposito, Maurizio Iacoangeli
OBJECTIVE: To evaluate the long term C1-C2 fusion rates, fracture healing and functional outcomes in geriatric patients with type II odontoid fracture treated with posterior fixation with polyaxial C1 lateral mass screws and C2 pars screws. METHODS: Twenty-one consecutive patients between 2005 and 2011 with Anderson and D'Alonzo type II odontoid fracture underwent a posterior atlanto-axial fixation with polyaxial C1 lateral mass screws and C2 pars screws. A long-term clinical and radiological follow-up was achieved in all patients with a mean follow-up period of 53...
September 1, 2016: World Neurosurgery
R Shane Tubbs, Christina M Kirkpatrick, Christian Fisahn, Joe Iwanaga, Marc D Moisi, David R Hanscom, Jens R Chapman, Rod J Oskouian
OBJECTIVE: We hypothesized that the entry site of the basivertebral vein into the basivertebral foramen of C2 might localize the subdental synchondrosis between the odontoid process and body of C2, which may be helpful for odontoid fracture classification. METHODS: Twenty-five dry adult C2 specimens underwent thin cut CT and were sectioned sagittally. The basivertebral foramen was then correlated to internal bony anatomy. 50 MRIs were reviewed and the location of the subdental synchondrosis determined...
August 30, 2016: World Neurosurgery
J Joestl, N Lang, A Bukaty, P Platzer
AIMS: We performed a retrospective, comparative study of elderly patients with an increased risk from anaesthesia who had undergone either anterior screw fixation (ASF) or halo vest immobilisation (HVI) for a type II odontoid fracture. PATIENTS AND METHODS: A total of 80 patients aged 65 years or more who had undergone either ASF or HVI for a type II odontoid fracture between 1988 and 2013 were reviewed. There were 47 women and 33 men with a mean age of 73 (65 to 96; standard deviation 7)...
September 2016: Bone & Joint Journal
Idiris Altun, Kasım Zafer Yuksel
STUDY DESIGN: Retrospective review. PURPOSE: We retrospectively reviewed our patients with ankylosing spondylitis (AS) to identify their patterns of spinal fractures to help clarify management strategies and the morbidity and mortality rates associated with this group of patients. OVERVIEW OF LITERATURE: Because of the brittleness of bone and long autofused spinal segments in AS, spinal fractures are common even after minor trauma and often associated with overt instability...
August 2016: Asian Spine Journal
Yasser Assaghir
STUDY DESIGN: Retrospective comparative clinical case series. OBJECTIVE: Burst C2 fractures are very rare. Treatment options include conservative treatment or fusion (anterior, posterior, or anterior and posterior). Anterior fusion addresses mainly hangman component. The bursting body usually needs posterior or combined anterior-posterior fusion, but both permanently sacrifice atlantoaxial motion. Can anterior-"first" approach preserve C1-C2 motion and restore function? METHODS: We report nine cases of burst C2 combined with C2-C3 spondylolisthesis and an odontoid fracture...
September 2016: Global Spine Journal
Christopher S Graffeo, Avital Perry, Ross C Puffer, Lucas P Carlstrom, Wendy Chang, Grant W Mallory, Michelle J Clarke
OBJECTIVE Type II odontoid fracture is a common injury among elderly patients, particularly given their predisposition toward low-energy falls. Previous studies have demonstrated a survival advantage following early surgery among patients older than 65 years, yet octogenarians represent a medically distinct and rapidly growing population. The authors compared operative and nonoperative management in patients older than 79 years. METHODS A single-center prospectively maintained trauma database was reviewed using ICD-9 codes to identify octogenarians with C-2 cervical fractures between 1998 and 2014...
August 19, 2016: Journal of Neurosurgery. Spine
Asdrubal Falavigna
No abstract text is available yet for this article.
August 19, 2016: Journal of Neurosurgery. Spine
Jared M Pisapia, Nikhil R Nayak, Ryan D Salinas, Luke Macyszyn, John Y K Lee, Timothy H Lucas, Neil R Malhotra, H Isaac Chen, James M Schuster
OBJECTIVE As odontoid process fractures become increasingly common in the aging population, a technical understanding of treatment approaches is critical. 3D image guidance can improve the safety of posterior cervical hardware placement, but few studies have explored its utility in anterior approaches. The authors present in a stepwise fashion the technique of odontoid screw placement using the Medtronic O-arm navigation system and describe their initial institutional experience with this surgical approach...
August 12, 2016: Journal of Neurosurgery. Spine
S Le Pape, R Gauthé, C Latrobe, J Leroux, X Roussignol, M Ould-Slimane
An episode of acute decompensation of cervical myelopathy occurred after an injury without fracture of an os odontoideum associated with a compressive retro-odontoid cyst. The 51-year-old female patient presented Fränkel C, Nurick grade 4 neurological status and pyramid syndrome. The initial MRI demonstrated an intramedullary T2 hyperintense signal in the context of spinal cord narrowing. The retro-odontoid cyst demonstrates atlantoaxial instability related to the os odontoideum. Harms C1-C2 arthrodesis without laminectomy was performed and the cyst disappeared completely...
October 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Umesh Srikantha, Kiran S Khanapure, Aniruddha T Jagannatha, Krishna C Joshi, Ravi G Varma, Alangar S Hegde
OBJECTIVE Minimally invasive techniques are being increasingly used to treat disorders of the cervical spine. They have a potential to reduce the postoperative neck discomfort subsequent to extensive muscle dissection associated with conventional atlantoaxial fusion procedures. The aim of this paper was to elaborate on the technique and results of minimally invasive atlantoaxial fusion. MATERIALS Minimally invasive atlantoaxial fusion was done initially in 4 fresh-frozen cadavers and subsequently in 5 clinical cases...
July 15, 2016: Journal of Neurosurgery. Spine
Ethan A Winkler, John K Yue, John Frederick Burke, Praveen V Mummaneni, Geoffrey T Manley, Phiroz E Tarapore, Sanjay S Dhall
INTRODUCTION: The management of axis fractures and particularly of odontoid fractures in the elderly remains controversial. As a greater segment of the US population lives past 80, it is becoming increasingly evident that published morbidity and mortality profiles of C2 fractures in younger cohorts (55+) are not applicable to octogenarians. Consequently, there is a need for further study in this specific population. METHODS: Using the National Sample Program (NSP) of the National Trauma Data Bank (NTDB), we performed a retrospective analysis of patients with age = 80 years and traumatic C2 fracture...
August 2016: Neurosurgery
Christopher S Graffeo, Avital Perry, Ross C Puffer, Lucas P Carlstrom, Wendy Chang, Grant W Mallory, Michelle J Clarke
No abstract text is available yet for this article.
August 2016: Neurosurgery
Deepak Agrawal
BACKGROUND: There is a relatively high incidence of screw misplacement during spinal instrumentation due to distortion of normal anatomy following spinal trauma. AIMS AND OBJECTIVES: To evaluate and share the initial experience with the use of neuro-navigated 3D O-arm(®) (Medtronic, USA) as compared to traditional 2D fluoroscopy in atrauma center in India. MATERIALS AND METHODS: In this retrospective study, consecutive patients of spinal injury who underwent screw fixation under O-arm guidance over nine-month period (July 2010 till March 2011) were evaluated for accuracy of screw placement...
July 2016: Asian Journal of Neurosurgery
Jennifer A Reynolds, Joel D MacDonald
BACKGROUND: Acute complex C2 vertebral body fracture specifically does not involve the odontoid process or C2 pars interarticularis. External stabilization can be effective but may prolong healing and increase morbidity. Many traditional surgical techniques can achieve internal stabilization at the expense of normal cervical motion. We describe direct surgical C2 pedicle screw fixation as an option for managing acute complex C2 vertebral body fracture. CASE DESCRIPTION: Three patients were treated with direct pedicle screw fixation of acute traumatic complex C2 vertebral body fractures...
September 2016: World Neurosurgery
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