Case Study: Surgical management of a 78 year old

with Odontoid Fracture Myelopathy

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Dr. Nakul Karkare

Dr. Nakul Karkare

Dr. Vedant Vaksha

Dr. Vedant Vaksha

Dr. Thor Robert Rhodin

Dr. Thor Robert Rhodin

Dr. Suhirad Khokhar, MD

Dr. Suhirad Khokhar

Dr. Kevin Kuo

Dr. Kevin Kuo

78 year old male presents with c/o bilateral hand clumsiness and balance problems. There is a remote history of fall about 4 years ago when he had neck pain and was treated in a cervical collar. There is no previous diagnosis of fracture.

He was having balance issues along with weakness in all 4 extremities. X rays, CT scan and MRI showed a non-union of odontoid fracture with pannus formation and fibrous union, instability with compression of spinal cord at C1-2 level.

AP and Lateral view of X rays showing a suspected odontoid fracture with instability at C1-2

AP and Lateral view of X rays showing a suspected odontoid fracture with instability at C1-2

CT scan of Cervical Spine showing non-union of odontoid with along with degenerative changes of Cervical spine

CT scan of Cervical Spine showing non-union of odontoid with along with degenerative changes of Cervical spine

MRI of Cervical Spine showing critical stenosis at C1-2 with posterior fibrous pannus at odontoid fracture

MRI of Cervical Spine showing critical stenosis at C1-2 with posterior fibrous pannus at odontoid fracture

After thorough discussion with the patient, an operative management was planned. Posterior C-12 decompression with stabilization with a C1-2 screw and rod fixation was performed.

Post-operative X-rays after C1-2 fusion and decompression surgery

Post-operative X-rays after C1-2 fusion and decompression surgery

Patient started recovery in his neurological status post operatively and was sent to rehab. He recovered near complete strength and coordination in 3-4 months post operatively.

I am Vedant Vaksha, Fellowship trained Spine, Sports and Arthroscopic Surgeon at Complete Orthopedics. I take care of patients with ailments of the neck, back, shoulder, knee, elbow and ankle. I personally approve this content and have written most of it myself.

Please take a look at my profile page and don't hesitate to come in and talk.

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