Os Odontoideum: A Cause of Atlanto-Axial Instability

Juhl, M; K, Seerup

doi:10.3109/17453678308992879

Cited by 23 publications

(11 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Congenital causes of AAI include the ligamentous laxity associated with Down syndrome and anomalies of the odontoid process [20][21][22][23]. Surgical treatment of pediatric patients with AAI poses a challenge to spine surgeons because of the patients' immature bone quality, extensive anatomical variability, and their smaller osseous structures.…”

Section: Discussionmentioning

confidence: 99%

Complications and outcomes of posterior fusion in children with atlantoaxial instability

et al. 2011

View full text Add to dashboard Cite

Introduction Atlantoaxial instability (AAI) is an uncommon disease in children. Surgical treatment of pediatric patients with AAI poses a challenge to spine surgeons because of the patients' immature bone quality, extensive anatomical variability, and smaller osseous structures. In this study, the authors report complications and outcomes after posterior fusion in children with AAI. MethodsThe authors reviewed medical records of patients 13 years old and younger with AAI who underwent posterior fusion in the Nagoya Spine Group hospitals, a multicenter cooperative study group, from January 1995 to December 2007. We identified 11 patients who underwent posterior fusion, and analyzed their clinical outcomes and complications. To determine if vertical growth within the construct continued after posterior fusion, in three patients at 5 or more years following occipito-cervical (O-C) fusion, intervertebral disc heights and vertebral heights between the fused and nonfused levels were compared on the final follow-up. Results The initial surgeries were C1-C2 fusions in six patients and O-C fusion in five patients. Successful fusion ultimately occurred in all patients, however, the complication rate related to the operations was high (64%). Complications included neurologic deterioration, pedicle fracture with pedicle screw insertion, C1 posterior arch fracture with lateral mass screw insertion, perforation of the skull with a head pin placement, and fusion extension to adjacent vertebrae. Two patients required reoperation. The mean fixed and non-fixed intervertebral disc heights on the final follow-up were 2.6 and 5.3 mm, respectively, showing that the disc height of the fixed level was less than the non-fused level. Each vertebra lengthened similarly between fused and non-fused levels except for C2 which had a lower growth rate than the other vertebrae. Conclusions A high complication rate should be anticipated after posterior fusion in children with AAI. Careful consideration should be paid to pediatric patients with AAI treated by screw and/or rod systems. After posterior fusion in pediatric patients, each vertebra continued to grow, in contrast the disc height decreased between fused levels.

show abstract

Section: Discussionmentioning

confidence: 99%

Complications and outcomes of posterior fusion in children with atlantoaxial instability

et al. 2011

View full text Add to dashboard Cite

show abstract

“…33,40,51,72,77,81,92 Michaels et al 51 reported on a 35-year-old taxi driver who was involved in a lowspeed head-on motor vehicle collision who died 4 days later. Autopsy revealed an os odontoideum that had compressed the spinal cord on flexion of the head.…”

Section: 73mentioning

confidence: 99%

“…This can have potentially devastating consequences to the spinal cord or vertebral arteries. 33,40,51,72,76,77,81,92 The results of this case report suggest that physical therapists should be cognizant of this condition and consider screening the upper cervical spine prior to manual or mechanical interventions to this region. At this time no consensus exists regarding which tests, if any, are appropriate, and there is no clear guidance on an appropriate sequence to testing the ligamentous structures of the upper cervical spine.…”

mentioning

confidence: 99%

Upper Cervical Ligament Testing in a Patient With Os Odontoideum Presenting With Headaches

Mintken

Metrick²,

Flynn³

2008

J Orthop Sports Phys Ther

View full text Add to dashboard Cite

“…[1][2][3][4][5][6][7] This condition might be rarely diagnosed in the elderly, either incidentally or on account of a neurological deficit. 8 The ability to manage the possible cases of OO is determined by the stability of atlantoaxial joint. 8,9 While OO under stable conditions might be considered for close observation and periodic radiological assessment, prophylactic stabilization might be considered for examining asymptomatic conditions with implied instability.…”

Section: Introductionmentioning

confidence: 99%

“…8 The ability to manage the possible cases of OO is determined by the stability of atlantoaxial joint. 8,9 While OO under stable conditions might be considered for close observation and periodic radiological assessment, prophylactic stabilization might be considered for examining asymptomatic conditions with implied instability. 5,9 Thus, instability, which characterizes the asymptomatic condition of OO, may put the patient at a risk of developing significant spinal cord injury even when subjected to minor trauma.…”

Section: Introductionmentioning

confidence: 99%

Os Odontoideum: Review Article

Rahimizadeh¹

2017

Orthop Res Traumatol Open J

View full text Add to dashboard Cite

Os odontoideum (OO) is defined as an ossicle with circumferential smooth margins and no osseous continuity with the body of axis. While the size of the ossicle is variable, it has a smooth surface, therefore, the cause of this condition has been presumed to be both congenital and traumatic. The possible cause of this condition has been implicated in its underlying etiology. However, patients with this condition may be asymptomatic or may be symptomatic of a variety of neurological deficits and vascular dysfunctions. The treatment of both the asymptomatic and symptomatic characteristics of this condition has undergone changes over the past few decades. The most challenging issue encountered is the management of OO with irreducible atlantoaxial dislocation. This outlines the objective of our discussion to examine the aforementioned subject extensively and review the appropriate potential strategies for the treatment of this condition.

show abstract

Os Odontoideum: A Cause of Atlanto-Axial Instability

Cited by 23 publications

References 6 publications

Complications and outcomes of posterior fusion in children with atlantoaxial instability

Complications and outcomes of posterior fusion in children with atlantoaxial instability

Upper Cervical Ligament Testing in a Patient With Os Odontoideum Presenting With Headaches

Os Odontoideum: Review Article

Contact Info

Product

Resources

About