The synchondrosis between the dens and the body of axis normally fuses between 5 and 7 years of age. Until this age, synchondrosis fractures can occur in children. Most synchondrosis fractures are conventionally treated by external immobilization alone. We report a 10-year-old child with odontoid synchondrosis fracture who was treated by C1 lateral mass and C2 pars screw rod fixation with a suc...

Traumatic atlantooccipital dislocation is generally considered incompatible with life. However, there have been isolated survivals from this injury, and a few patients initially have minimal neurologic deficits disproportionate to the gravity of their injury, a feature that has not been adequately stressed. The potentially catastrophic results of delayed therapy make early radiographic detectio...

The authors describe a unique retraction device adapted for anterior odontoid screw placement. A rigidly fixed tubular retractor system obviates the need for dissecting the longus colli muscles as well as for excessive retraction of the trachea, esophagus, and recurrent laryngeal nerve. The proper trajectory for screw placement can be determined by fine manipulation of the retractor as determin...

Introduction Atlantoaxial instability has been described as a manifestation of ankylosing spondylitis (juvenile and adult onset), reactive arthritis, juvenile idiopathic arthritis, and rheumatoid arthritis; however, it has rarely been reported as an early manifestation of these disorders (1). Instability of the atlantoaxial joint may lead to impingement on the cord and brainstem. There may also...

A number of approaches have been attempted to address the treatment of acute odontoid fractures, spanning from conservative treatment with an external orthotic device to posterior C1-C2 arthrodesis or anterior screw fixation. The current report describes stabilisation of such fractures with a C1 supralaminar hook and a C2 pars interarticularis screw construct. Two patients with odontoid fractur...

Methods Cross-sectional analysis of craniometric parameters from individuals submitted to magnetic resonance at an outpatient imaging center between 2011 and 2012. Results Of 181 analyzed cases, the Welcker basal angle averaged 128.96º (SD 6.51), median distance between apex of the odontoid and Chamberlain's line was 2.27 mm (IQR -1.23-4.47) and the median clivus-canal angle was 150.5º (IQR 1...

INTRODUCTION In human, the cervical spine region is very susceptible to impact injury. The complex structures of C1 and C2 serve to transmit the weight of the cranium to the greatly similar structural cervical spine from C3 caudally. Application of sudden disruption forces will detach the junction of the cervico-cranium with the pars interarticularis of the neural arch of C2 from the lower cerv...