Combined fractures of the odontoid process and upper thoracic spine:two case reports

Abstract

We describe two cases of combined fractures of theodontoid process and upper thoracic spine that have notbeen previously reported. The first patient, a 21-year-old man,sustained an odontoid process fracture with posterior displacementand a fracture-dislocation injury at T4/5 in a motorcycleaccident. The second patient, a 66-year-old woman, fellfrom a cliff and sustained an odontoid process fracture withposterior displacement and a bursting fracture at T3 and T4with rotation. The first patient exhibited complete paraplegiabelow the T5 level of the spinal cord. The second patientescaped neurological deficit. Both underwent anterior screwfixation of the odontoid process and posterior fusion of theupper thoracic spine. In both cases the cervical spine seemedto be in hyperextension, and the upper thoracic spine experiencedsudden flexion and rotation forces.