Doctors Lounge - Orthopedics Answers
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Forum Name: Spinal problems and back pain
Question: odontoid and c2 fractures
|Delanie - Sun Aug 19, 2007 4:19 pm||
40 y/o male went 12 days with a unidentified comminuted fracture through the body of C2 extending to involve the odontoid process base and extending into the right portion of the odontoid process. the fracture extends to the right lateral mass but posteriorly appears intact. There is a retropulsed fragment identied, posteriorly.
the base of the odontoid narrowing the AP dimenion of the canal to 1 cm at the level of the base of the odontoid peg. As well there is mild anterior displacement of the odontiod of 6 mmwith as well mild anterior angulation of 10 degrees. the lateral mass of C1 are intact. Facets show normal alignment.
Question is halo or surgery, and the out come of each option. Anterior surgery not an option.
|Dr. Chan Lowe - Wed Sep 12, 2007 10:21 pm||
This is a bit of a case dependent answer. Unfortunately, I am not knowledgeable enough about these types of fractures to recommend surgery or a halo. I have seen many patients placed in halo's with good outcomes; however, with the displaced portions of the fracture surgery may be needed.
I would recommend you discuss this with a neurosurgeon that can look at your scans to see exactly how the fractures line up and advise you better on which approach would be most appropriate.
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