• Journal of Trauma and Injury
• /
• v.27 no.1
• /
• pp.1-4
• /
• 2014

Occipito-atlanto-axial subluxation is a type of high cervical injury. Misdiagnosis of this instability might cause several complications, including neurologic deficits. A radiologic evaluation must be performed and specific parameters that imply cervical instability must be confirmed. Full understanding of these parameters may prevent not only delayed diagnosis but also unexpected complication. We report a case of delayed detection of a cervical instability and emphasize the role of proper diagnosis.

• Journal of Korean Neurosurgical Society
• /
• v.64 no.5
• /
• pp.837-842
• /
• 2021

An atlantoaxial subluxation from the unstable Os odontoideum by the failure of proper integrations between the embryological somites might be a commonly reported pathology. However, its suspicious origin or paralleled occurrence with other congenital anomalies of vertebral body might be a relatively rare phenomenon. The authors present two cases, who simply presented with clinical signs of prolonged, intractable cervicalgia without any neurological deficits, revealed this rare feature of C1-2 subluxation from the unstable, orthotropic type of Os odontoideum that coincide with congenitally fused cervical vertebral bodies between C2-3. Surprisingly, in one case, when traced from the lower cervical down to the thoracic-lumbar levels during the preoperative work-up process, was also compromised with multi-level butterfly vertebrae formations. Presented cases highlight the association of various congenital vertebrae anomalies and the rationale to fuse only affected joints.

• Journal of Korean Neurosurgical Society
• /
• v.37 no.5
• /
• pp.345-349
• /
• 2005

Objective: Anterior screw fixation provides the best anatomical and functional results for type II odontoid process fracture (type II-A, II-N, and II-P) with intact transverse ligament. The purpose of this study is to evaluate the usefulness of the 4.5mm diameter, cannulated Herbert screw in anterior screw fixation. Methods: From Jan. 2003 to Feb. 2004, consecutive 10cases of type II odontoid process fractures were treated with anterior screw fixation using a Herbert screw. The Herbert screw has double threads, with different pitches on the distal and proximal ends. It has no head, so it can be inserted through articular cartilage and buried below bone surface. It was originally developed for treating scaphoid fractures. Results: There were 8male and 2female patients whose ages ranged from 15 to 67years (mean 42.1years). The fracture type was type II-A in 4patients, II-N in 3 patients, and II-P in 3 patients. The fracture line was oblique downward and backward in 6cases, oblique downward and forward in 1 case, and horizontal in 3cases. The range of follow-up was 5 to 18months (mean 12months). Bone fusions were achieved in all cases without any instrumental failures or postoperative complications. Conclusion: The Herbert screw is very useful in anterior fixation for type II odontoid process fracture. This series showed successful results also in type II-A odontoid fracture when treated with the Herbert screw, but further more studies are required.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.11
• /
• pp.1461-1468
• /
• 2000

Objective : The aim of this study is to evaluate clinical outcome of anterior screw fixation for type II odontoid fractures for the prliematim of atlanatoaxial mobility. Methods : Between 1995 and 1999, we treated 15 cases of type II odontoid fractures by anterior screw fixation among 44 cases of odontoid fractures. Thece included 14 males and 1 female aged from 23 to 63 years, with a mean age of 39.7 years. The causes of trauma were traffic accident in 13 cases, slip down in 1 and fall down in 1. The fracture type was type II-P in 7 cases, type II-A in 3, type II-N in 2 and type II-A and P in 3. The fracture line was oblique downward and backward in 6 cases, oblique downward and forward in 3 and horizontally in 6. The range of follow up was 4 to 47 months(mean 26.5 months). Results : Adequate reduction and fixation were obtained in 12 cases. Three cases in which fracture type and line were type II-A and oblique downward forward were failed, so posterior transarticular screw fixation was performed. All except 3 failed cases had adequate cervical movement and stability. There were no operative mortality nor morbidity. Conclusion : Anterior screw fixation provides the best anatomical and functional results for type II odontoid fracture with intact transverse ligament when fracture line is horizontal or oblique downward and backward. But it is limited when fracture line is oblique downward and forward.

• Journal of Veterinary Clinics
• /
• v.30 no.6
• /
• pp.499-502
• /
• 2013

An eight-year-old, castrated male, Poodle dog was presented with a bite wound in the neck region. Clinical examination revealed non-ambulatory signs of tetraparesis with deep pain, and upper motor neuron changes in all limbs. Fractures of the transverse process of C1 and the dorsal spinous process of C2 were observed on the radiographs and the computed tomography (CT). Conservative therapy was performed for 1 week. However the neurological problems were not alleviated until 7 days after injury. The owners agreed to perform surgical stabilization. The surgical stabilization was performed 7 days after presentation. Ventral stabilization was performed with screws, K-wires and bone cement. The dog stood up independently after 4 weeks and was able to walk 6 weeks postoperatively. In this report we suggest that using combined stabilization techniques are effective for this type of cervical fracture in which the dorsal and ventral structures of the vertebra are severely disrupted.