Recognition of the incidence of odontoid fractures as well as the associated morbidity and unexpectedly high mortality rates has prompted significant changes in the management of these fractures in the past decade. Nonsurgical management of type II odontoid fracture has historically been associated with a high nonunion rate . Treatment depends on the location of the fracture within the C2 vertebrae defined by the Anderson and D'Alonzo classification system and the patient's risk factors for nonunion (failed bone healing)
A type II odontoid fracture is a fracture through the base of the odontoid process. This injury occurs most typically when there is an excessive extension of the cervical spine, and the anterior arch of C1 pushes dorsally (backward) with sufficient force on the odontoid process (dens) to fracture the odontoid process at its base . 1, 2 The growing elderly population in the United States has seen the incidence of odontoid fractures more than double over the past decade. 2 The incidence of odontoid fractures is approximately 21.4 per 100 000 inpatient Medicare admissions, and it is estimated that the cost of treating these fractures exceeds $1.5 billion.
The Roy-Camille classification of fractures of the odontoid process of C2 depends on the direction of the fracture line 1. The level of fracture line as described by the Anderson and D'Alonzo classification is not predictive of the degree of instability or the risk of non-union Fractures of the odontoid process. Govender S(1), Maharaj JF, Haffajee MR. Author information: (1)King Edward VIII Hospital, Durban, South Africa. We treated 183 patients with fractures of the odontoid process (109 type II, 74 type III) non-operatively. Union was achieved in 59 (54%) with type-II fractures Odontoid fractures have a significant morbidity in the elderly (>65 years) population. Type II fractures in this population are recommended to be treated operatively with a weak recommendation, and if treated nonoperatively using a hard collar immobilization device. Type III odontoid fractures in
Type II fractures are the most common and potentially the most dangerous and occur as a transverse fracture across the base of the odontoid process, just superior to the body of the axis. About 15% of these patients will have neurological injury; these fractures are unstable and require some type of immobilization Type III odontoid fracture. A type III odontoid fracture is a fracture through the body of the C2 vertebrae and may involve a variable portion of the C1 and C2 facets. Epidemiology. Type III fractures account for 39% of all odontoid fractures 1). Etiolog However, fractures of the odontoid process in past populations are uncommon and therefore such injuries may be easily overlooked. This paper describes alterations of the first and second cervical vertebrae, the atlas and axis, of a male individual of advanced age from the medieval necropolis of Maro (Málaga, Spain) Fractures of the odontoid process account for ∼9% of all cervical spine fractures ().Anderson and D'Alonzo classify odontoid fractures by location.Type I oblique fractures occur through the apex of the odontoid process, Type II fractures occur through the waist of the odontoid process, and Type III fractures extend into the body of the C2 vertebra () (A) Type I odontoid fracture represents an avulsion of the tip of the dens at the insertion site of the alar ligament. Although mechanically stable, it is associated with life-threatening..
The odontoid process, also known as the dens, is an upward projectile of bone that arises from the front part of the center of the axis vertebra. (The axis is the 2nd highest spinal bone.) The atlas is the first bone of your neck; it sits on top of the axis. (The skull sits on top of the atlas. . The precise incidence of nonunion of odontoid fractures does not emerge from the literature surveyed Fracture of dens. Fractures of the dens, not to be confused with Hangman's fractures, are classified into three categories according to the Anderson Alonso system: Type I Fracture - Extends through the tip of the dens. This type is usually stable. Type II Fracture - Extends through the base of the dens Nachemson A: Fracture of the odontoid process of the axis. A clinical study based on 26 cases. A clinical study based on 26 cases. Acta Orthop Scand 29 : 185 - 217 , 1960 Nachemson A: Fracture of the odontoid process of the axis Odontoid Process Fracture. General considerations. Most dens fractures are caused by motor vehicle accidents and falls. About 1/3 of C-spine injuries occur at C2 and about ½ at C6-C7. As expected, most fatal cervical spine injuries occur at C1 or C2. Most odontoid fractures occur with flexion, extension and rotation. Normal anatomy
A type I fracture (< 5% of cases) is an oblique fracture through the upper part of the odontoid process. This type of fracture occasionally is associated with gross instability due to traction. Odontoid process' fracture is the most common post-traumatic upper cervical spine fracture, the classification of these fractures, proposed in 1974 by Anderson & D'Alonzo, remains the most widespread because of its simplicity and it odontoid process. Type I1 is a fracture occurring at the junction of the odontoid process with the body of the second cervical vertebra. In Type 111, the fracture line extends down- ward into the cancellous portion of the body and is really a fracture through the body o A mass at the level of the odontoid process was seen with density similar to bone that corresponded to an old fracture of the odontoid process. Due to the changes noted in the density of the bone, the fracture has healed as pseudarthrosis. An important cervical canal stenosis was noted and immediately the patient was put in a rigid cervical. Odontoid fractures account for approximately 20% of all fractures of the cervical spine. They represent the most common cervical spine injury for patients older than 70 years, the majority being type II fractures (65-74%), which are considered to be relatively unstable. The management of these fractures is controversial. Possible treatment options are either conservative or surgical
Aims: We wished to investigate the role of the cervical ligaments in maintaining atlantoaxial stability after fracture of the odontoid process. Methods: We dissected eight fresh-frozen cadaveric cervical spines to prepare the C1 and C2 vertebrae for biomechanical analysis. The C1 and C2 blocks were mounted and biomechanical analysis was performed to test the stability of the C1-C2 complex. Type II Odontoid Fracture/Odontoid Fracture, the odontoid process, or dens, is a superior projecting bony element from the second cervical vertebrae (C2
Odontoid Fractures. 1. Elderly 92 yo male w/ h/o osteopenia presents to ED from nursing home w/ neck pain after a mechanical fall. Pt tripped while trying to walk to restroom. Denies LOC. Pt c/o moderate midline cervical pain upon application of c-collar by EMS on scene .5 cm long and 1 cm wide • Articulating facets : The superior facets do not form an articular pillar with the inferior facets, but are anterior to the latter • Thick lamina, stout pedicle and large spinous process 5. C2 fractures • Odontoid fracture • Hangman fracture. Odontoid fractures continue to pose clinical challenges. These injuries are classified into type 1, II or III according to the location of fracture of the odontoid process. The Cervical Spine Research Society had used the Anderson and D'Alonzo classification to decide on the mode of treatmen The 'classical' or 'Hangman' neck fracture involves the odontoid peg (process) of the second cervical vertebra (C2), and is described as an axial, dens or odontoid peg fracture in both the veterinary and human literature. Possible surgical treatment in both foals and adult horses requires a technique that allows decompression, anatomical alignment and stabilisation of the odontoid fracture
Subgroups of odontoid fractures (types II and III) Patients with type II TOF, as opposed to type III fractures, were older (median 83 versus 78 years, p = 0.016) and had a higher degree of cystic degenerations of the odontoid process (p = 0.036; Supplemental Table S6) Odontoid Screw Fixation. Division of Neurological Surgery, Barrow Neurological Institute, Mercy Healthcare Arizona, Phoenix, Arizona. Thirty-two patients who sustained Type II fractures of the odontoid process were surgically treated with anterior odontoid screw fixation. Odontoid screw fixation is the preferred method for stabilization of. Type II- Fracture at the base of the odontoid process. This is the most common type of odontoid fracture, but is also very troublesome. The nonunion rate of a type II odontoid fracture is 20-80% due to interruption of blood supply. The risk factors for nonunion include patients' age of 60 years or older, more than 6 mm of displacement of the.
Read Odontoid Process Fracture in Children: Delayed Diagnosis and Successful Conservative Management with a Halo Cast. A Report of Two Cases, Journal of Bone and Joint Surgery on DeepDyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips (1979). Fracture of the Odontoid Process: An Experimental and Clinical Study. Acta Orthopaedica Scandinavica: Vol. 50, No. sup177, pp. 1-95
Fractures of the axis are the most common cervical spine fracture in the elderly population. The Anderson and D' Alonzo classification system, most commonly applied to these fractures, identify Type II odontoid fractures at the junction of the odontoid process with the body of the second cervical vertebra.These fractures account for approximately 9% of all cervical spine fractures and. . In survivors there is a risk of ongoing damage to the spinal cord and paralysis. People with these fractures are often treated conservatively, which entails stabilisation of the neck in devices such as a 'Halo' (external frame) and/or rigid collar for several months In our case, the location of the lesion was distinctive: it involved the odontoid process and body of the axis, leaving a very thin cortex of odontoid and thus could have led to fracture of the odontoid process during normal activity of the atlantoaxial joint. Such a fracture might have resulted in instability of the atlantoaxial joint or even.
Cervical spine fractures are common fractures due to spine trauma. Odontoid fracture is responsible for 20% of cervical spine fractures. Vertebral artery injuries (VAIs) had widely focused in this setting due to its occurrence with upper cervical fractures. In our case of study, a 42-year-old female presented in the hospital's emergency department with a history of cervical spine injury. Transoral and transnasal odontoidectomy complications: A systematic review and meta-analysis. Source: PubMed (Add filter) Published by Clinical Neurology And Neurosurgery, 11 July 2016. alleviate symptoms associated with pathological processes involving the odontoid process, decompression is often required, including.. Thus, in cases of fragment dislocation and/or damaged transverse ligament, a direct screw to the odontoid process stabilizes the odontoid fragment, enabling fracture healing. Non-dislocated fractures in younger children can be treated by minerva cast for 4 to 6weeks. 17 , 18 Also dislocated, reducible odontoid fractures can be managed by 6weeks. Fracture Of Odontoid Process Bioinformatics Tool Laverne is a handy bioinformatics tool to help facilitate scientific exploration of related genes, diseases and pathways based on co-citations. Explore more on Fracture Of Odontoid Process below! For more information on how to use Laverne, please read the How to Guide However, fracture of the odontoid process rarely occurs. Odontoid fractures are mostly manifested after trauma to the cervical spine. However, an RA patient may undergo an odontoid fracture spontaneously, and it is supposed to be related with a long disease duration and steroid therapy [1,2]. To our knowledge, atraumatic odontoid fractures i
Dens fractures (DF) constitute the commonest type of fracture of the cervical spine, representing 5-15% of all cervical spine fractures and are divided in three types. Type I refers to a fracture involving the superior part of the odontoid process while Type II involves its base and Type III affects the body of C2 Odontoid process fracture. The small fragment is rotated anteriorly and superiorly. Portions of the ruptured cruciate ligament and of the rectorial membrane are entrapped in the wide fracture gap. The apical ligament is avulsed. Only the dura is intact. In addition in this specimen, uncovertebral and facet joint injuries as well as several disc. We report on a 57-year-old woman with frequent and powerful retrocollis. The involuntary movements combined with rheumatoid arthritis and osteoporosis led to a fracture of the axial odontoid process
Type I fracture (less than 5% of cases): an oblique fracture through the upper part of the odontoid process. It is usually associated with gross instability due to traction forces applied to, and subsequent injury of, the apical and/or alar ligaments The odontoid process is a bony protusion upwards off the vertebral body of C2. These are called odontoid fractures and this particular one is the more difficult type to treat. It is called a type 2 odontoid fracture. The C6 and C7 fractures were simple fractures of the back of the canal. They are called laminar fractures and are of no.
A type 2 fracture is a break at the base of the dens, and a type 3 fracture is when the break goes into the main portion of the second vertebre. How is an Odontoid Fracture diagnosed? A patient with this type of fracture comes in after a whiplash type injury complaining of worsening neck pain We treated 183 patients with fractures of the odontoid process (109 type II, 74 type III) non-operatively. Union was achieved in 59 (54%) with type-II fractures. All type-III fractures united, but in 16 patients union was delayed. There was no correlation between union and the clinical or radiological outcome of the fractures. Selective vertebral angiography, carried out in 18 patients ten. The C2 fracture accounts for nearly 19% of spinal fractures and 55% of cervical fractures (in patients with head injury). Within C2 fractures, the hangman's fracture accounts for 23% of occurrences while the odontoid or dens fracture accounts for 55% of them. Societ base of the odontoid process leading to a Type II (Anderson-D'Alonzo classification) fracture in most cases (6). The axis ring (Harris) is a very important sign in the detection of low odontoid fractures. It can be the only radiological sign of a type III (low) odontoid fracture in an elderly patient. As these are unstabl The fractured but normally developed odontoid process (asterisk) is highlighted by sagittal reconstruction of the post-mortem CT examination. The fracture site is located at the synchondrosis (S) between the base of the odontoid process and the body of the axis (C2)
e odontoid without apparent trauma. The mean patient age was 58 years and all had a long history of rheumatoid arthritis. No trauma was considered to be the cause of the fracture. This is a fracture caused by arosion and osteoporosis of the odontoid process due to rheumatoid synovitis, aging and steroid therapy. In addition, another cause is a dynamic load produced from the instability. A type I fracture (< 5% of cases) is an oblique fracture through the upper part of the odontoid process. This type of fracture occasionally is associated with gross instability due to traction forces applied to, and subsequent injury of, the apical and/or alar ligaments. This is an avulsion injury to the tip of the odontoid and usually is stable
Evaluation of Conservative Treatment of Acute Fracture of the Odontoid Process of Axis with a Halo-Vest 299. 5. Discussion . Surgical therapy is recommended for patients with a fresh fracture of the odontoid process of the axis because it allows for early discharge and successful rehabilitation. However, surgery cannot always be conducted. If a pa on and surgery (spine fusion) is commonly required in this group. Odontoid fractures were classified into three types, and, in a series of forty-nine fractures, two avulsion, thirty-two body, and fifteen basilar fractures were treated and followed for an average of twenty-two months (range, six months to nineteen years). Body fractures are most prone to non-union and surgery (spine fusion) is. Odontoid fractures type II according to Anderson and d'Alonzo are not uncommon in the elderly patients. Still, due to the paucity of evidence the published treatment guidelines are far from equivocal. This systematic review focuses on the published results of type II odontoid fracture treatment in the elderly with regard to survival, nonunion, and complications odontoid process and the body of the axis Unstable High rate of malunion 3 39-42% Fracture that extends down into the cancellous bone of the body of the axis and is in reality a fracture of the body of C2 Usually stable High rate of fusion Type 1 fractures Type 1 odontoid process fractures are rare and somewhat controversial. They are though
No trauma was considered to be the cause of the fracture.This Is a fracturs caused by erosion and osteoporosis of the odontoid process due to rheumatold synovitis, aging and storoid therapy, in addition, another cause is B dynamic load produced from the instability accompanying atlantoaxial subluxation working on the odontoid in cervical wtGhSiOn Odontoid process fracture involve only a subset of cervical spine fractures. In small childrens, this fracture typically involves the cartilaginousplate that separates the odontoid process from the body of the axis. Odontoid processfracture is rare in children less than 7 years of age. Key words: odontoid process, fracture, 2 years of age. This page includes the following topics and synonyms: Cervical Spine Fracture, C-Spine Fracture, Clay Shovelers Fracture, Odontoid Process Fracture, Hangmans fracture, Jefferson Fracture, Cervical Wedge Compression Fracture, C1 Fracture, C2 Fracture, Cervical Teardrop Fracture, Cervical Spinous Process Fracture, Cervical Burst Fracture, Cervical Facet Dislocation, Cervical Fracture Study Design Case report. Objective Odontoid process fractures represent an uncommon injury in small children, with their optimal management remaining unclear..
SICOT-J, official journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT An odontoid screw can be placed for type-II odontoid fractures in good alignment with an intact transverse ligament in the acute setting. There is concern about the placement of the odontoid screw in the elderly population and instances of delayed non-union Fractures. The dens is a protuberance (process or projection) of the C2 vertebra or axis which is also called the odontoid process. It is the most prominent feature of the c2 vertebra. It has a small contraction where it connects with the main body of the vertebra. It is originally made up of an upward extension of the cartilaginous mass.
Objective: To evaluate the bone area of the odontoid process through computed tomography and its.. odontoid fracture: Orthopedics A fracture caused by 'sudden forward and backward movement of the head with respect to the trunk', with a shearing of the dens from the body of C2, with forward movement by the transverse ligament, with backward movement by the anterior arch of C1; flexion is the most common mechanism of injury; extension. Immobilization of cervical spine in a hard collar is the basic element of conservative treatment following odontoid fracture or it is applied as an aid supporting the process of osteosynthesis [4,5,6]. In both cases, it can be expected there will be consequences of long-term immobilization of the cervical spine in a hard collar, such as.
Fractures of odontoid process can occur in all age groups. (1) These fractures have been reported with increasing with age, although the incidence of subaxial cervical spine fractures decreases with age.(2) In younger patients, these fractures are usually secondary to high-energy trauma but in elderly, tend to result from low-energy trauma. In odontoid fractures, surgical stability can be achieved by either fracture fixation of the C2 body to the odontoid process or by arthrodesis of the C1-C2 motion segment. The desire to maintain cervical motion is attractive, thus odontoid screw fixation has been increasingly reported. Lessening or obviating the need for halo immobilization is. The ICD-10-CM code S12.100 might also be used to specify conditions or terms like closed fracture axis, odontoid process, closed fracture axis, posterior arch, closed fracture axis, spinous process, closed fracture axis, spondylolysis, closed fracture axis, transverse process , closed fracture axis, tricolumnar, etc. Unspecified diagnosis codes.
the old fracture of the odontoid process (Fig. 1A). MRI of the cervical spine revealed the old fracture of the odon-toid process and myelopathy at the C1/C2 levels (Fig. 1B). She underwent spine surgery with open reduction, C1-2 with temporary lateral mass screw fixation, C1, right. Thereafter, her neurological progression ceased. Thre Fractures of the Odontoid Process of the Axis Fractures of the Odontoid Process of the Axis Anderson, Lewis D.; D'Alonzo, Richard T. 2004-09-01 00:00:00 Odontoid fractures were classified into three types, and, in a series of forty-nine fractures, two avulsion, thirty-two body, and fifteen basilar fractures were treated and followed for an average of twenty-two months (range, six months to.
Type II odontoid process fractures (a type of fracture in the second cervical vertebrae) are the most common cervical spine fractures in the elderly occurring usually after a low-energy fall. With the aging population the incidence is increasing Conventional to- mography in two planes is not only used for the exclusion, Fractures of the odontoid process are dangerous injuries but also for the detailed visualization of the fracture, in of the upper cervical spine, because of their potential in- particular, with regard to therapy planning [13, 17, 19]. stability
Fusion of Odontoid Nonunion Fractures. A sudden or traumatic blow to the base of the skull or upper neck can result in a shear force that fractures the odontoid process. The odontoid process is a peg-like structure of bone that's part of the C2 vertebra. It sticks up inside the C1 vertebra, which is shaped like an open ring bony impingement of the anterior portion of the foramen magnum on the odontoid process. classification of odontoid fractures. andersen and D'alonzo (location of fracture) Type 1 odontoid fx. oblique avulsion of the tip of the dens. type 2 odontoid fx. fracture through th waist Definitions. Type I: Avulsion fracture from tip of odontoid at insertion of alar ligament. Type II: Transverse fracture through base of odontoid. Type III: Oblique fracture extending from base of odontoid into body of C2 The ICD-10-CM code S12.120S might also be used to specify conditions or terms like fracture of odontoid process, fracture of odontoid process, fracture of odontoid process type i, fracture of odontoid process type iii or type iii fracture of odontoid process of axis. The code is exempt from present on admission (POA) reporting for inpatient. fractures of the odontoid process of the axis author anderson ld; d'alonzo rt univ. tennessee coll. med., memphis, tenn. source j. bone joint surg., amer. ed.; u.s.a. Anterior odontoid screw fixation was first reported by Nakanishi 1) and Bohler 2).This procedure provides immediate spinal stability, preserves the normal rotation between C1-2, allows the best anatomical and functional outcome for type II odontoid fracture, and is associated with rapid patient mobilization, minimal postoperative pain and a short hospital stay