Transoral C2 osteotomy for treatment of severe irreducible atlantoaxial dislocation after odontoid fracture: about 3 cases

IF 1.4 4区医学 Q4 CLINICAL NEUROLOGY Neurochirurgie Pub Date : 2025-03-01 Epub Date: 2025-01-10 DOI:10.1016/j.neuchi.2025.101637

Daniel Startun , Kaissar Farah , Mikael Meyer , Thomas Graillon , Henry Dufour , Stéphane Fuentes

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Abstract

Objective

To report the outcomes of transoral C2 osteotomy (or partial odontoidectomy) and posterior fixation, regarding efficacy and safety, in patients with severe irreducible atlantoaxial dislocation (IAAD) following odontoid fracture.

Methods

Transoral C2 osteotomy, soft tissue resection, with or without facet joint release, followed by posterior fixation were performed on 3 patients (2012, 2016, 2023) who were suffering from severe IAAD after an odontoid fracture with spinal cord compression. The radiological and clinical outcomes were then assessed.

Results

All 3 patients had satisfactory release of their spinal cord compression and good reduction of their IAAD. No neurological or vascular complications were reported. No instrumentation failure, radiolucent zone formation around the screws, infection, or recurrence of dislocation were encountered neither. Bony fusion was successfully achieved in every patient.

Conclusion

Transoral C2 osteotomy (or partial odontoidectomy), soft tissue resection, with or without facet joint release, followed by posterior fixation is an effective and reliable method to treat severe IAAD after odontoid fractures.

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经口C2截骨治疗齿状突骨折后严重寰枢脱位约3例。

目的：报道经口C2截骨术（或部分齿状突切除术）和后路固定治疗齿状突骨折后严重不可复位寰枢脱位（IAAD）患者的疗效和安全性。方法：对3例（2012年、2016年、2023年）齿状突骨折合并脊髓压迫后发生严重IAAD的患者行经口C2截骨、软组织切除、小关节松解或不松解后后路固定。然后评估放射学和临床结果。结果：3例患者均获得满意的脊髓压迫解除和良好的IAAD复位。无神经或血管并发症报道。没有发生内固定失败、螺钉周围形成透光区、感染或脱位复发。所有患者均成功实现骨融合。结论：经口C2截骨术（或部分齿状突切除术）、软组织切除术，伴或不伴小关节松解，后路固定是治疗齿状突骨折后重度IAAD的有效、可靠的方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurochirurgie 医学-临床神经学

CiteScore

2.70

自引率

6.20%

发文量

100

审稿时长

29 days

期刊介绍： Neurochirurgie publishes articles on treatment, teaching and research, neurosurgery training and the professional aspects of our discipline, and also the history and progress of neurosurgery. It focuses on pathologies of the head, spine and central and peripheral nervous systems and their vascularization. All aspects of the specialty are dealt with: trauma, tumor, degenerative disease, infection, vascular pathology, and radiosurgery, and pediatrics. Transversal studies are also welcome: neuroanatomy, neurophysiology, neurology, neuropediatrics, psychiatry, neuropsychology, physical medicine and neurologic rehabilitation, neuro-anesthesia, neurologic intensive care, neuroradiology, functional exploration, neuropathology, neuro-ophthalmology, otoneurology, maxillofacial surgery, neuro-endocrinology and spine surgery. Technical and methodological aspects are also taken onboard: diagnostic and therapeutic techniques, methods for assessing results, epidemiology, surgical, interventional and radiological techniques, simulations and pathophysiological hypotheses, and educational tools. The editorial board may refuse submissions that fail to meet the journal''s aims and scope; such studies will not be peer-reviewed, and the editor in chief will promptly inform the corresponding author, so as not to delay submission to a more suitable journal. With a view to attracting an international audience of both readers and writers, Neurochirurgie especially welcomes articles in English, and gives priority to original studies. Other kinds of article - reviews, case reports, technical notes and meta-analyses - are equally published. Every year, a special edition is dedicated to the topic selected by the French Society of Neurosurgery for its annual report.