Fractures of the odontoid process

Govender, S.; Maharaj, J.; Haffajee, M.R.

doi:10.1302/0301-620x.82b8.10601

Cited by 26 publications

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“…The rst reason was that type II odontoid fracture was located at the axis transition region, which looked like the neck of the axis. The second reason was the frequent occurrence of nonunion in type II odontoid fracture in the case of conservative treatment [12] . The nonunion incidence of type-II fractures following conservative therapy is reported to range between 15% and 85% [12,13] .…”

Section: Resultsmentioning

confidence: 99%

“…The second reason was the frequent occurrence of nonunion in type II odontoid fracture in the case of conservative treatment [12] . The nonunion incidence of type-II fractures following conservative therapy is reported to range between 15% and 85% [12,13] . Nonunion of type II odontoid fracture is caused by a variety of factor, among which, disrupted blood supply due to trauma has been considered to make great contribution [14,15] .…”

Section: Resultsmentioning

confidence: 99%

“…In this study, the mean CT value of the base of the odontoid (318.38 ± 98.82) was signi cantly lower than the odontoid (397.45 ± 93.59) and the body of the axis (651.35 ± 188.32). Govender et al [12] reported that the mean difference of surface area between type-II and type-III fractures was 134.72 mm 2 , which might in uence healing after fracture. Iwanaga et al [21] and Heggeness et al [22] reported that the odontoid process was under destructive forces from the apical ligament, which can lead to nonunion of type II odontoid fracture.…”

Section: Resultsmentioning

confidence: 99%

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One Possible Cause for the Frequent Occurrence and Nonunion of Type II Odontoid Fracture 

Dong¹,

Hu²,

Zhong³

et al. 2020

Preprint

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Background. To analyze the underlying causes of frequent occurrence and nonunion of type II odontoid fracture.Methods. CT scans along with 3D imaging software (Mimics software) were used to measure the bone density of the axis. The axis was divided into three parts, including the odontoid of the axis (the first part), the base of the odontoid (the second part) and the body of the axis (the third part). The CT value of the axis was measured and analyzed in different axial planes from top to bottom, followed by calculation and comparison of the mean CT value of the three parts of the axis.Results. The mean CT value of the odontoid (the first part), base of the odontoid (the second part) and body of the axis (the third part) was 651.35±188.32, 318.38±98.82 and 397.45±93.59, respectively. In addition, the interval variation of CT value of different axial planes was initially decreased and further increased with the change of axial planes from top to bottom.Conclusion. The mean CT value of the base of the odontoid was significantly lower than that of the odontoid or the body of the axis. Therefore, the base of the odontoid was the transition region of shape and bone density, which may be one possible cause for the frequent occurrence and nonunion in the type II odontoid fracture in axis fracture.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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One Possible Cause for the Frequent Occurrence and Nonunion of Type II Odontoid Fracture 

Dong¹,

Hu²,

Zhong³

et al. 2020

Preprint

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“…Therefore, external immobilization (including traction, halo-vest fixation, brace immobilization, and so on) was used commonly in types I and III odontoid fractures. Type II odontoid fracture is on connection of odontoid and vertebral body, and it makes injury in blood vessel commonly7,16). It makes fracture healing poor, so external immobilization is not proper to treat type II odontoid fracture.…”

Section: Discussionmentioning

confidence: 99%

Clinical Results of Odontoid Fractures according to a Modified, Treatment-Oriented Classification

Cho

Kim

et al. 2017

Korean J Spine

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ObjectiveOdontoid fracture is common in cervical injury, representing about 20% of total cervical fractures. Classic odontoid fracture classification focused on anatomy of fracture site has no treatment recommendation and a modified treatment-oriented classification of odontoid fracture was suggested in 2005. We reviewed our odontoid fracture patients to assess the feasibility and efficacy of Grauer’s classification.MethodsBetween October 2000 and September 2015, we collected data from patients who came to our institute for odontoid fracture. Demographic data of patients was reviewed, and neck visual analog scale (VAS) score and fusion rate were assessed by reviewing electronic medical records retrospectively.ResultsSixty-nine patients out of a total of eighty two odontoid fracture patients were reviewed according to Grauer’s classification. Neck VAS of all subtypes in odontoid fracture classification were decreased at last follow-up (p=0.001). Overall fusion rate was 88.4% at last follow-up. Concordance rate between Grauer’s recommendation and our treatment was 69.9%, especially in type II with the concordance higher than 80%. Complication was minimal representing 7.2%, only in types I and III.ConclusionIn this study, there were statistically significant improvement in all subtypes in terms of neck VAS at the last follow up, especially in types II and III. Grauer’s classification appears to be meaningful to decide treatment plan for odontoid fractures, especially type II odontoid fracture.

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“…Typically the fracture is accompanied by posterior displacement of the odontoid fragment and C1 relative to the body of C2. Three types of odontoid fractures exist [12, 13]. Type 1 dens fractures involve avulsion of the tip by the alar ligament and must be distinguished from a well-corticated os odontoideum.…”

Section: Upper Cervical Spine Injuriesmentioning

confidence: 99%

MDCT and MRI evaluation of cervical spine trauma

et al. 2013

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PurposeCervical spine injuries following major trauma result in significant associated morbidity and mortality. Devastating neurological injury, including complete and incomplete tetraplegia, are common sequelae of cervical spine trauma and cause profound and life-altering medical, financial, and social consequences. Most cervical spine injuries follow motor vehicle accidents, falls, and violence. The proliferation of multidetector computed tomography allows for fast and accurate screening for potential bony and vascular injuries. Magnetic resonance imaging is useful for evaluation of the supporting ligaments and the spinal cord after the patient has been stabilised.ConclusionCervical spine injuries are approached with much caution by emergency room clinicians. Thus, it is essential that radiologists be able to differentiate between a stable and unstable injury on MDCT, as this information ultimately helps determine the management of such injuries.Teaching Points:MDCT and MRI are complementary and both may be needed to define injuries and determine management.MDCT rapidly evaluates the bones, and MRI is superior for detecting ligament and cord injuries.Injury to one of the three spinal columns may be stable, and injuries to more than one are unstable.Instability may cause abnormal interspinous and interpedicular distances, or cervical malalignment.Fractures of the foramen transversarium are associated with vertebral arterial dissection.

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Fractures of the odontoid process

Cited by 26 publications

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One Possible Cause for the Frequent Occurrence and Nonunion of Type II Odontoid Fracture

One Possible Cause for the Frequent Occurrence and Nonunion of Type II Odontoid Fracture

Clinical Results of Odontoid Fractures according to a Modified, Treatment-Oriented Classification

MDCT and MRI evaluation of cervical spine trauma

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Fractures of the odontoid process

Cited by 26 publications

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One Possible Cause for the Frequent Occurrence and Nonunion of Type II Odontoid Fracture&nbsp;

One Possible Cause for the Frequent Occurrence and Nonunion of Type II Odontoid Fracture&nbsp;

Clinical Results of Odontoid Fractures according to a Modified, Treatment-Oriented Classification

MDCT and MRI evaluation of cervical spine trauma

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One Possible Cause for the Frequent Occurrence and Nonunion of Type II Odontoid Fracture

One Possible Cause for the Frequent Occurrence and Nonunion of Type II Odontoid Fracture