![]() ![]() ![]() Transoral anterior release, odontoid partial resection, and reduction combined with posterior fusion are effective, reliable, and safe procedures for the treatment of IAAD caused by odontoid fracture malunion. The reactive new bone formation around the odontoid fracture may play a role in preventing further movement and development of myelopathy. No screw loosening, implant migration or implant failures, atlantoaxial redislocation, or signs of instability were observed in any of the patients during the follow-up period. Conservative nonoperative treatment is appropriate for stable undislocated displaced odontoid fractures. Furthermore, the average improvement in neurological function was 87.4 %. There are many influencing factors leading to appropriate treatment of odontoid fractures such as age, bone quality, arthrosis, classification, and type of the fracture. The injury can also cause the C2 to move out of alignment with the bone right below it, known as the C3. The average of patients JOA scores at the final follow-up was significantly higher than that of their preoperative scores. A fracture can be a partial or complete break in a bone. The patients were followed up for an average of 19.6 months (ranged from 9 to 36 months). The odontoid process and atlas were dislocated to an extreme posterior and right position (Fig. Bony fusion was seen in all patients postoperatively. Cervical CT scan and 3-D reconstruction digital anatomy confirmed an odontoid fracture associated with a partial cortical avulsion fracture of the anterior tubercle of the atlas. Neurologic status was evaluated using the Japanese Orthopaedic Association (JOA) scoring system.Īll seven patients had complete release, and satisfactory reduction. C1-C2 were then fixed through pedicle screws and rods, and then fused posteriorly by single stage. Anterior atlantoaxial release was performed through anterior transoral approach, followed by partial resection of the odontoid process. This study included seven cases of IAAD caused by odontoid fracture malunion, collected from January 2008 to January 2011. Any associated atlantoaxial instability can be treated from the same exposure. Plate (VSP) and screws permit rigid fixation in compression mode with 100 fusion. We also evaluated the clinical efficacy of this surgery. Most irreducible unstable odontoid fractures can be anatomically realigned by anterior extrapharyngeal approach by facet joint manipulation. This study aimed to introduce a surgical method of transoral anterior release, odontoid partial resection, and reduction with sequential posterior fusion for the treatment of IAAD caused by odontoid fracture malunion. However, no study has reported the surgical method for the management of IAAD caused by odontoid fracture malunion. Treatment may take the form of surgery or wearing a brace. Type III: A fracture occurring in the body of the axis underlying the dens. Several techniques have been introduced to manage irreducible atlantoaxial dislocation (IAAD). Type I: A fracture of the upper part of the process (the tip.) Type II: A Fracture at the base of the dens. Odontoid fractures are among the most common fractures in the elderly, and controversy exists regarding treatment. ![]()
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