Atlantoaxial Spondyloptosis with Type II Odontoid Fractures: A Report of 2 Cases. Issue 4 (7th October 2022)

• Record Type: Journal Article
• Authors: Lachance, Andrew D.; Gerstl, Jakob V. E.; Florman, Jeffrey E.
• Is Part Of: JBJS case connector. Volume 12:Issue 4(2022)
• Publication Date: 2022-10-07
• Subjects: Spondyloptosis -- spine -- neurosurgery -- atlas -- axis -- odontoid -- atlantoaxial -- internal fixation -- traction -- closed reduction; Orthopedic surgery -- Case studies -- Periodicals; Orthopedic surgery -- Periodicals; Orthopedics; Orthopedic Procedures; Orthopedic surgery; Periodicals; Electronic journals; Case studies; Periodicals; 616.7
• DOI: 10.2106/JBJS.CC.22.00230
• Languages: English
• ISSNs: 2160-3251

Abstract

Abstract : Case: Two patients with delayed presentations of neck pain and fixed kyphotic deformity after trauma were found to have atlantoaxial spondyloptosis (AAS) with type II dens fractures. Owing to the rarity of AAS, outcomes and optimal treatment are not well understood. In both cases, closed reduction was achieved with a dynamic overhead traction setup, followed by posterior surgical stabilization with C1-2 screw fixation. Conclusion: Closed reduction remains a challenge because of the marked deformity of interlocking C1-C2 joints. However, patients with chronic fixed atlantoaxial dislocation due to odontoid fractures can be safely managed with closed reduction and fusion of C1-C2. Level of Evidence: Level V.