ArticleJournal of neurosurgery. Case lessons2024
Anterior odontoid screw fixation of a type III odontoid fracture aided by transoral digital manipulation: illustrative case.
Article in Journal of neurosurgery. Case lessons, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundOdontoid process fractures make up 10%-20% of all cervical spine fractures, with type III fractures having a considerable amount of heterogeneity. Most simple type III fractures can be managed nonoperatively. However, 21% of complex type III fractures with significant displacement and angulation are inadequately treated with external immobilization and require surgery. Achieving a reduction via traction can pose a great challenge during intraoperative manipulation, especially when presentation is delayed. OBSERVATIONS: A 36-year-old male patient, who presented 2 weeks after a motor vehicle crash, had a Glasgow Coma Scale score of 14 and intact motor and sensory function. A craniocervical computed tomograpy scan revealed a normal brain with a type III odontoid fracture. The patient underwent anterior odontoid screw fixation (AOSF) aided by a transoral digital manipulation to achieve a reduction of the irreducible proximal fracture segment at 8 weeks postinjury. The treatment resulted in preserved neurological function and a satisfactory odontoid fracture reduction. LESSONS: Delayed presentation of a complex type III odontoid fracture can be challenging to treat; however, AOSF with the aid of transoral digital manipulation of the irreducible proximal segment can help to achieve good reduction and fusion with the preservation of neurological function in a young patient. https://thejns.org/doi/10.3171/CASE24294.
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