Odontoid fractures account for 5% to 15% of all cervical spine injuries and 1% to 2% of all spine fractures. Type II fractures are the most common fracture pattern in elderly patients. Treatment (rigid and non-rigid immobilization, anterior screw fixation of the odontoid and posterior C1-C2 fusion) remains controversial and represents a unique challenge for the treating surgeon. The aims of tre...

Some issues related to participation in certain sports by persons with Down syndrome require clarification. Since 1965 there have been occasional reports about a condition described at various times as instability, subluxation, or dislocation of the anticulation of the first and second cervical vertebrae (atlantoaxial joint) among persons with Down syndrome.’’5 This condition has also been foun...

Controversy exists as to the most effective management option for elderly patients with type II odontoid fractures. The purpose of this study is to evaluate outcomes associated with rigid cervical collar and posterior fusion surgery. Patients with ≥ 50% odontoid displacement were treated with posterior fusion surgery including C1-2 (PSF group, n = 25, average age = 80 years). Patients with < 50...

Radiography of the lateral neck was performed on all children with Down's syndrome aged 4-15 in the Southern Derbyshire health district (n = 67) and a random selection of adults (n = 94). Atlantoaxial instability, defined as a gap of over 4 mm, was present in seven (10%) children and two (2%) adults. Odontoid hypoplasia, defined as an odontoid peg two standard deviations below the mean in an ag...

A 78-year-old woman presenting with fever and occipital headache was referred to our service with suspicion of meningitis. Neurological examination was normal except for cervical stiffness. CRP level was increased to 18.7 mg/dl. Cerebrospinal fluid examination was normal. Cervical CT image at C1/C2 level showed right dominant semicircular calcifications posterolateral to the odontoid process (d...

The atlas (Fig. 2) does not have a vertebral body – this has been absorbed into the axis vertebra, to form the odontoid process (Fig. 3). A thick anterior arch remains, extending into and joining the two lateral masses, on which are the superior atlantal joint facets, which articulate with the occipital condyles; and the inferior joint facets of the axis. The posterior arch is thinner than the ...

BACKGROUND Osteoid osteoma is a primary benign bone lesion, which constitutes about 10% of all primary benign bone tumors and 3% of all primary bone tumors. The spine is involved in 10% of the cases, and the lumbar spine is the most commonly affected whereas the tumor is rarely seen in the cervical spine. With regard to the osteoid osteoma being located at the odontoid process of the axis, limi...

In type-II fractures of the odontoid process, the treatment is either conservative in a halo vest or primary surgical stabilisation. Since nonunion, requiring prolonged immobilisation or late surgery, is common in patients treated in a halo vest, the identification of those in whom this treatment is likely to fail is important. We reviewed the data of 69 patients with acute type-II fractures of...

The cervical spine was examined with MR imaging and conventional radiography in 23 patients with severe rheumatoid arthritis. All patients had neck pain and 17 also had neurologic symptoms. MR provided detailed information about soft-tissue lesions, vertebral dislocation, and narrowing of the spinal canal. Pannus surrounding the odontoid process was revealed in 14 patients, all with horizontal ...

Introduction Odontoid fractures occur commonly in a bimodal age distribution. In younger patients the injury is associated with high energy trauma; however fractures in the elderly population are associated with low energy trauma such as falls. Above the age of 70 years, fractures of the odontoid peg are the most common cervical spine injury, with the majority being type II by the Anderson and ...