Vertebral artery injury and severely displaced odontoid fracture: the case for early reduction

Sullivan, Michael P.; McCormick, John; Arlet, Vincent

doi:10.1007/s00586-013-2917-z

Cited by 9 publications

(18 citation statements)

References 19 publications

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“…Therefore, although odontoid fracture and dislocation may be obvious on imaging, the symptoms of spinal cord injury are frequently mild. In the present case, as in some of the reported cases, the patient's neurological symptoms did not parallel the significant radiographic fracture‐dislocation.…”

Section: Discussionsupporting

confidence: 61%

“…Surgical treatment of odontoid luxation fracture remains controversial. Our review of published reports revealed that different authors performed different surgical procedures for type II odontoid fractures associated with posterolateral atlas complete dislocation. In our case, after closed reduction had failed we operated via a posterior approach.…”

Section: Discussionmentioning

confidence: 78%

“…A search of published reports revealed that type II odontoid fracture combined with atlas posterolateral dislocation is rare, only nine cases with adequate radiography data having been reported thus far; reduction with cervical traction was achieved in only three of eight cases (Table ). Many factors can make reduction of this type of injury difficult, the central factor likely being bilateral interlocking of the atlantoaxial lateral mass joint.…”

Section: Discussionmentioning

confidence: 99%

“…Type II odontoid fracture associated with atlas posterolateral dislocation is a rare upper cervical injury, only such nine cases having been reported so far in English. Because so few case reports have been published, no consensus has been reached regarding the extent of the damage and treatment of this type of injury. Reduction was achieved by traction in only three of nine previously reported cases.…”

Section: Introductionmentioning

confidence: 98%

“…Fortunately, all those patients who survived had no or mild neurological deficit. Closed reduction was achieved in two cases by applying skull traction or Halo followed by posterior fixation. A failed closed reduction was reportedly successfully set by posterior open reduction and internal fixation.…”

Section: Introductionmentioning

confidence: 99%

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Atlantoaxial Joint Interlocking Following Type II Odontoid Fracture Associated with Posterolateral Atlantoaxial Dislocation: a Case Report and Review of Published Reports

Huang

Sheng

et al. 2016

Orthopaedic Surgery

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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. After many surgical attempts at setting had failed because of interlocking of the lateral mass joints, reduction was achieved by compressing the posterior parts of the atlantal and axial screws. Odontoid bone union and C1,2 posterior bone graft fusion were eventually obtained by the 12-month follow-up. The patient had a complete neurological recovery with no residual neck pain or radiculopathy.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Atlantoaxial Joint Interlocking Following Type II Odontoid Fracture Associated with Posterolateral Atlantoaxial Dislocation: a Case Report and Review of Published Reports

Huang

Sheng

et al. 2016

Orthopaedic Surgery

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Vertebral artery injury following combination Jefferson fracture of C1 and Type II odontoid fracture: A case report

Meng,

Zhang,

Song

et al. 2024

Clinical Case Reports

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Key Clinical MessageTraumatic posterior atlantoaxial dislocation combined with Jefferson fracture and odontoid process fracture with vertebral artery injury is rare. The management of such injury raises controversial issues and is still open to debate. A 74‐year‐old Chinese male presented with sustained neck pain and stiffness after falling from height. The patient was neurologically intact. Preoperative radiographs demonstrated a Jefferson burst fracture with a posterior dislocation of the atlantoaxial joints and odontoid process Anderson and D'alonzo type II fracture. A computed tomography angiography (CTA) showed an occluded left vertebral artery. Coil embolization in the proximal portion of the occluded vertebral artery was performed to prevent further cerebral infarction due to distal embolization of the thrombus. Then a second stage occipito‐cervical fusion was performed to reconstruct cervical spine stability. A systematic screening of blunt trauma vertebral artery injuries through CTA is required when dealing with upper cervical fracture. For cases with vertebral artery occlusion secondary to cervical spine injury, endovascular treatment preceding cervical spine surgery is a feasible and a safe treatment.

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Expert’s comment concerning Grand Rounds case entitled “Vertebral artery injury and severely displaced odontoid fracture: the case for early reduction” (by M.P. Sullivan, J.D. McCormick, V. Arlet)

Kandziora

Langheinrich

2013

Eur Spine J

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This is an interesting case report describing an excellent clinical result achieved by indirect decompression of the vertebral artery by ''early'' reduction with traction in a trans-odontoid atlanto-axial luxation fracture [1]. The trans-odontoid luxation fracture is a highly unstable traumatic lesion of the atlanto-axial complex most often associated with an Anderson type II fracture of the odontoid (Fig. 1). In many cases, this luxation can already be suspected on the conventional X-rays by the position of the atlas and the significant dislocation regularly exceeding the complete width of the odontoid (Fig. 1a, b). In addition, it is characterised by CT-confirmed unilateral-or bilateral jumped (Fig. 1c, d) and sometimes even locked lateral

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Vertebral artery injury and severely displaced odontoid fracture: the case for early reduction

Cited by 9 publications

References 19 publications

Atlantoaxial Joint Interlocking Following Type II Odontoid Fracture Associated with Posterolateral Atlantoaxial Dislocation: a Case Report and Review of Published Reports

Atlantoaxial Joint Interlocking Following Type II Odontoid Fracture Associated with Posterolateral Atlantoaxial Dislocation: a Case Report and Review of Published Reports

Vertebral artery injury following combination Jefferson fracture of C1 and Type II odontoid fracture: A case report

Expert’s comment concerning Grand Rounds case entitled “Vertebral artery injury and severely displaced odontoid fracture: the case for early reduction” (by M.P. Sullivan, J.D. McCormick, V. Arlet)

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