The authors present their experience with surgical treatment of odontoid process fractures using a direct screw fixation technique via an anterolateral retropharyngeal approach. Nine consecutive patients have been operated on with this technique. There were two deaths unrelated to the surgery, and anatomical union with conservation of the craniospinal hinge mobility was achieved in the remaining seven patients. The direct screw fixation technique appears feasible, efficient, and logical.
✓ The authors report three cases of cervical degenerative cysts causing medullary or radiculomedullary compression. Anatomicopathological examination confirmed the fibrous nature of the cyst wall and the absence of a synovial layer. One of the cysts was embedded in the ligamentum flavum, whereas the other two were most lateral and adherent to the facet joint. The physiopathogenesis of these cysts is discussed.
The authors report 18 cases of pedicular fractures of C-2. The characteristics of these fractures are discussed, and the authors conclude that these lesions are more correctly called "pedicular-isthmus" fractures. A technique of screw fixation of the pedicle is presented. This was found to be a simple and safe method of repair, giving consistently good anatomical and functional results.
The authors report 102 cases of severe lesions of the lower cervical spine, in which operation was mandatory. The characteristics of these fractures are discussed, together with the different operative procedures. Posterior osteosynthesis using Roy-Camille's plates was preferred.
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