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CC BY 4.0 · Rev Bras Ortop (Sao Paulo) 2024; 59(S 01): e68-e72
DOI: 10.1055/s-0042-1748812
Relato de Caso

C1-C2 Transarticular Anterior Fixation for the Treatment of Atlantoaxial Traumatic Dislocation: A Clinical Case

Article in several languages: português | English
Paulo Gil Ribeiro 
1   Setor de Coluna Vertebral, Serviço de Ortopedia, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
,
Francisco Fernandes 
1   Setor de Coluna Vertebral, Serviço de Ortopedia, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
,
Paulo Costa 
1   Setor de Coluna Vertebral, Serviço de Ortopedia, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
,
Ana Catarina Quintas 
1   Setor de Coluna Vertebral, Serviço de Ortopedia, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
,
Paulo Lourenço 
1   Setor de Coluna Vertebral, Serviço de Ortopedia, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
2   Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
,
Diogo Lino Moura 
1   Setor de Coluna Vertebral, Serviço de Ortopedia, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
2   Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
› Author Affiliations Financial Support The authors declare that they have received no financial support from public, commercial, or non-profit sources to conduct the present study.
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Abstract

Fractures of the odontoid apophysis are one of the most frequent lesions in the elderly population, and an increasingly preponderant problem with the progressive aging of the world population.

In the present work, we report a clinical case of an 88-year-old male patient who suffered a fall resulting in a type-II fracture of the odontoid apophysis on the Anderson-D'Alonzo classification. Given the age and comorbidities of the patient, we decided to perform osteosynthesis of the fracture through anterior fixation with a transarticular screw in combination with fixation with an odontoid screw.

This technique enables the necessary stability for the consolidation of Anderson-D'Alonzo's type II odontoid apophysis fracture, with the advantage of the lower levels of dissection of the cervical extensor musculature and hemorrhage resulting from this aggression when compared with the posterior approach; moreover, it is a readily-available technique that yields clear benefits in the treatment of this pathology in the geriatric population.

Keywords

axis cervical vertebra - geriatrics - odontoid apophysis - osteosynthesis - spinal fractures

Study carried out at the Spinal Unit, Orthopedics Service, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal.




Publication History

Received: 02 December 2021

Accepted: 28 March 2022

Article published online:
20 June 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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  • Referências

  • 1 Gembruch O, Ahmadipour Y, Lemonas E, Müller O. The Anterior Transarticular Fixation of C1/C2 in the Elderly With Dens Fractures. Int J Spine Surg 2020; 14 (02) 162-169
    CrossrefPubMedSearch in Google Scholar
  • 2 Robinson AL, Möller A, Robinson Y, Olerud C. C2 Fracture Subtypes, Incidence, and Treatment Allocation Change with Age: A Retrospective Cohort Study of 233 Consecutive Cases. BioMed Res Int 2017; 2017: 8321680
    CrossrefPubMedSearch in Google Scholar
  • 3 Magerl F, Seemann PS. Stable Posterior Fusion of the Atlas and Axis by Transarticular Screw Fixation. In: Kehr P, Weidner A. editors. Cervical Spine I: Strasbourg 1985. Vienna: Springer Vienna; 1987: 322-327
    Search in Google Scholar
  • 4 Harms J, Melcher RP. Posterior C1-C2 fusion with polyaxial screw and rod fixation. Spine 2001; 26 (22) 2467-2471
    CrossrefPubMedSearch in Google Scholar
  • 5 Josten C, Jarvers JS, Glasmacher S, Heyde CE, Spiegl UJ. Anterior transarticular atlantoaxial screw fixation in combination with dens screw fixation for type II odontoid fractures with associated atlanto-odontoid osteoarthritis. Eur Spine J 2016; 25 (07) 2210-2217
    CrossrefPubMedSearch in Google Scholar
  • 6 Barbour JR. Screw fixation in fracture of the odontoid process. S Aust Clin 1971; 5 (01) 20
    Search in Google Scholar
  • 7 Böhler J. Anterior stabilization for acute fractures and non-unions of the dens. J Bone Joint Surg Am 1982; 64 (01) 18-27
    CrossrefPubMedSearch in Google Scholar
  • 8 Anderson LD, D'Alonzo RT. Fractures of the odontoid process of the axis. J Bone Joint Surg Am 1974; 56 (08) 1663-1674
    CrossrefPubMedSearch in Google Scholar
  • 9 Josten C, Spiegl UJ. C1–C2 Anterior Transarticular Fixation and Grafting. In: Koller H, Robinson Y. editors. Cervical Spine Surgery: Standard and Advanced Techniques: Cervical Spine Research Society - Europe Instructional Surgical Atlas. Springer International Publishing; 2019
    CrossrefSearch in Google Scholar
  • 10 Sen MK, Steffen T, Beckman L, Tsantrizos A, Reindl R, Aebi M. Atlantoaxial fusion using anterior transarticular screw fixation of C1-C2: technical innovation and biomechanical study. Eur Spine J 2005; 14 (05) 512-518
    CrossrefPubMedSearch in Google Scholar