Abstract
Authors report a case of odontoid type II fracture with an irreducible posterior dislocation successfully treated by one-stage transoral resection of the dens and posterior cervical fusion. A 5:8-year-old woman fell down from a bicycle and had a bruise in the right forehead. She had an immediate tetraparesis with greater weakness in the upper extremities. Radiographic studies revealed an odontoid type II fracture with IJO mm posterior displacement of the atlas and the odontoid process. MRI demonstrated posterior displacement of the spinal cord due to the dislocation. She was placed in halo tongs with up to 10 kg of cervical traction for 15 days, which could not achleve anatomical alignment. On the 16th hospital day, transoral resection of the dens and posterior wiring with aLltOlogoLIS bone fusion was performed. We placed a bone plug between the laminae of C1 and C2, put a stainless buckle plate on the graft and wired them into position. After operation, a halo vest was applied for eight weeks. The patient did well postoperatively. Dynamic flexion and extension roentgeno-grams of the cervical spine revealed stability. We concluded that the one-stage transoral resection of the odontoid process and posterior C1/C2 fixation was a useful treatment for irreducible odontoid type II fracture with a posterior dislocation.
