REDUCTION AND INTERNAL FIXATION OF COMPLEX FRACTURES OF THE ODONTOID BY THE TRANSORAL APPROACH

Geraldo De Sá Carneiro,Aline Figueiras Da Trindade,Deoclides Lima Bezerra Júnior,Juliano Rodrigues Chaves,Saul Cavalcanti De Medeiros Quinino

doi:10.1590/s1808-185120181704172951

Geraldo De Sá Carneiro, Aline Figueiras Da Trindade + Show 3 more

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https://doi.org/10.1590/s1808-185120181704172951

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Abstract

ABSTRACT Type II odontoid fractures with irreducible posterior displacement are uncommon, and can cause spinal cord compression, respiratory failure and even death. Treatment is usually surgical, with transoral decompression and posterior fusion or with reduction and fusion of C1-C2 by the transoral approach. We describe a case of type II odontoid fracture with irreducible posterior atlantoaxial dislocation that was treated exclusively by the transoral approach with osteosynthesis of the odontoid, thus preserving functional segmental mobility. Level of Evidence III; therapeutic study.

Highlights

IntroductionOdontoid fractures are relatively common, corresponding to 20% of all acute cervical fractures
In which we carry out reduction and osteosynthesis of the fracture using a transoral approach
We report a case of a 34 year-old patient, male, healthy, not smoker, non osteoporotic, who was victim of motorcycle accident

Summary

Introduction

Odontoid fractures are relatively common, corresponding to 20% of all acute cervical fractures. Fracture of the odontoid process with posterior atlantoaxial dislocation is uncommon. Patients with this type of injury rarely survive. Its occurrence is not well known in the literature, but it is believed that there are two incidence peaks: one in young people and another in people aged 70 and older.[1]. These fractures are generally realigned with cervical traction. Those cases that reduction is not achieved are a challenge. Anterior decompression through transoral approach is proposed, with subsequent fusion or decompression and anterior fusion C1-C2 with specific instruments.[2,3,4]

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