Trauma in elderly patients is often difficult to evaluate and neck injuries are probably more common than is documented. A case is described of a missed odontoid peg fracture with the unusual presentation of dysphagia and a rapidly developing cervicodorsal kyphos (head falling forward), which may well have been anticipated at several points in the management chain. The lessons to be learned are...

STUDY DESIGN Multicenter prospective cohort study. OBJECTIVE To identify patient and treatment characteristics associated with treatment success or failure in the management of odontoid fractures. SUMMARY OF BACKGROUND DATA Odontoid fractures are the most common cervical spine fractures in the elderly and represent a significant management challenge with widely divergent views regarding ope...

A four-year-old boy presented with a solitary bone cyst in the odontoid process and body of the axis. Plain radiographs showed a radiolucent lesion with extreme thinning of the cortex and MRI demonstrated a high signal intensity in the interlesional matrix. The cystic component extended into the body of the axis through a defect in the epiphyseal plate. At operation, the cavity of the cyst was ...

Traumatic intracranial vertebral artery injury is a relatively rare but potentially fatal disease. We present a case of a 63-year-old man who presented with sudden onset of loss of consciousness after hitting his head. After immediate resuscitation, he showed quadriplegia and absence of spontaneous breathing. Brain and cervical spine magnetic resonance imaging revealed an atlantoaxial subluxati...

Atlanto-axial and lower cervical subluxations are frequently present in rhematoid arthritis and ankylosing spondylitis. Vertebral erosions, particularly of the odontoid process, can often be demonstrated. Rheumatoid involvement of the occipito-atlanto-axial joints may cause a vertical translation of the cervical spine with respect to the skull; at times, this is associated with true basilar inv...

Metastasis to the odontoid peg is a rare condition. We report a case where such a metastasis from an oesophageal adenocarcinoma caused problems in both diagnosis and management. This is the first case to our knowledge to originate from a primary oesophageal adenocarcinoma. CASE REPORT. A 58 year old male was admitted with dysphagia and weight loss. Investigations revealed a lower oesophageal ad...

STUDY DESIGN A retrospective comparative study. OBJECTIVE The aim of this study was to compare the outcomes of anterior screw fixation and posterior temporary-fixation in the treatment of Anderson-D'Alonzo type II odontoid fractures. SUMMARY OF BACKGROUND DATA Posterior C1-C2 temporary-fixation can spare the motion of C1-C2 in the treatment of odontoid fractures. However, it is unknown whet...

A human vertebra was modelled using the finite element method (FEM), to investigate likely sites of failure under prescribed loading. The FEM stress analysis proved that the stress distributions in the second cervical vertebra (axis) are influenced by the direction of the applied load on the anterior surface of the odontoid process. The regions of high compressive stress could be found on the i...

Study Design Case report and review of the literature. Objective A retro-odontoid mass is a rare cause of cervical compression and myelopathy. The differential diagnosis includes the following: metastatic disease, primary tumor, collagen disorder, or inflammatory disease. Calcium pyrophosphate dihydrate (CPPD) deposition has been referred to as "crowned dens syndrome" when there are periodontoi...