Case study 12 - Type 3 Odontoid Fracture - treated with traction and fusion скачать в хорошем качестве

Case study 12 - Type 3 Odontoid Fracture - treated with traction and fusion

Odontoid fracture with anterior displacement Odontoid fractures are among the most common fractures of the cervical spine, accounting for about 10% of all cervical spine injuries (Boughton et al., 2015). These injuries tend to be more silent clinically unless they cause spinal cord compression, which is rare due to the relatively large SAC at this level in the cervical spine (Pryputniewicz and Hadley, 2010). Odontoid fractures can be caused by both extension and flexion forces. When a flexion/shear force is the cause of an odontoid fracture, there is anterior displacement of C1 on C2, although this may also be seen as sequelae of an extension injury. The treatment of odontoid fractures depends on the level of the fracture. Odontoid fractures are classified by the Anderson and D’Alonzo classification. Type 1 fractures occur at the tip of the odontoid and are typically treated nonoperatively. Type 2 fractures are through the waist of the odontoid process. These fractures have a high rate of nonunion due to a poor vascular supply. Type 2 fractures are usually treated surgically (halo versus C1–C2 posterior fusion), unless they occur in an elderly patient with comorbidities that prevent surgery. Type 3 fractures extend into the C2 body, and can typically be treated nonsurgically (Boughton et al., 2015). The odontoid process accounts for about 37% of the stiffness of the C1–C2 complex; the surrounding ligaments (alar ligament, transverse ligament, ALL, PLL) account for the remaining stiffness (Dickman et al., 1996). If injury to these ligaments is seen on magnetic resonance imaging (MRI) in addition to fracture, it could indicate an unstable C1–C2 complex; this situation may necessitate surgery (Dickman et al., 1996). #casestudy #trauma #neurosurgery #neckpain #cervicalfracture #spinefracture #neckfracture #c2fracture #halovest