Case series on isolated type 2 odontoid fracture

Abstract

Introduction: Among all cervical fractures, type II odontoid fractures are 66% that are mainly due to high energy trauma, for example motorbike accidents. For surgery, there are two acceptable methods; anterior odontoid screw fixation (AOSF) and posterior cervical instrumented fusion (PCIF). Case descriptions: In this, retrospective case series, we described presentation of 5 such cases, mostly after trauma. Ages for one of them was of 17 years, another was of 23 years and three cases were of 45 years, (three more patients presented but refused to have surgery). Three patients had no neurological deficits but only neck pain. One patient had weakness in extremities while one patient was in coma due to brain trauma. Placement of screws and spinal stabilization with early mobilization was achieved in all patients. There were no neurological symptoms after surgery. Only one patient had decreased power as was before and it takes time to recover, but he was able to move his neck without any pain. In patient who had a low GCS due to brain trauma, the odontoid process was aligned successfully with screw fixation. Discussion: Usually patients have no neurological symptom but has neck pain. Patient selection was based on radiological characteristics and clinical status. AOSF helps to retain most of the cervical rotation; show quick recovery, has higher fusion rate and less risk of damage to vital and surrounding tissues and safer approach. Therefore, it can be considered as the first line of treatment but in carefully selected patients.

Keywords

• Spine
• Odontoid process
• Bone screws
• Early mobilization
• Fracture avulsion