Atlanto-axial deformity secondary to a neglected odontoid fracture: a report of six cases.
We reviewed 6 patients with atlanto-axial (C1-2) deformities secondary to neglected odontoid fractures. All patients (except one with recent injury) were asymptomatic for a long period before development of neck pain or myelopathy, despite obvious subluxation and kyphotic deformities at the C1-2 joint complex. Patients were treated conservatively, except for one who underwent posterior spinal fusion and occiput-to-C2 decompression for progressive myelopathy. The reactive new bone formation around the odontoid fracture may play a role in preventing further movement and development of myelopathy. Conservative treatment should be considered for neglected odontoid fractures in elderly patients with stable non-progressive C1-2 deformity.
Ho
Angela Wing-hang
AW
Department of Orthopaedics and Traumatology, Caritas Medical Centre, Kowloon, Hong Kong. angelahowh@yahoo.com
Ho
Yuen-fong
YF
D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D019416:Head Movements; D006801:Humans; D016916:Joint Deformities, Acquired / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D058069:Neglected Diseases; D009809:Odontoid Process / Q000293:injuries*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000150:complications* / Q000175:diagnosis; D014057:Tomography, X-Ray Computed