Cheng Li, Jingzhu Duan, Lei Li


June 2017, Volume 27, Issue 3, pp 292 - 297 Case Report Read Full Article 10.1007/s00586-017-5167-7

First Online: 12 June 2017

Purpose

To report a case of complex odontoid fracture malunion accompanied by atlantoaxial dislocation which was treated with a new surgical approach.

Methods

A 53-year-old female was admitted due to progressive symptoms with a stiff limp and unsteady gait. Preoperative examination, diagnostic radiography, computed tomography, and magnetic resonance imaging were performed following admission. The examinations showed odontoid fracture malunion, an old right axial zygapophyseal fracture, atlantoaxial dislocation, and spinal cord injury. Anterior submandibular retropharyngeal odontoid osteotomy and posterior atlantoaxial fusion were then performed.

Results

Good reduction of the atlantoaxial dislocation was gained. The cervical spinal cord compression was significantly relieved and neurological function was also significantly improved.

Conclusion

Anterior submandibular retropharyngeal odontoid osteotomy and posterior atlantoaxial fusion fixation is an effective method for treating IAAD associated with odontoid fracture malunion, it avoids the adverse effects of anterior transoral odontoid osteotomy and provides a new option for the treatment of odontoid fracture malunion associated with atlantoaxial dislocation.


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