To start with, we’ll start with the clinical case, there’s a 78 year old male presents with bilateral hand clumsiness and balance problems. He has a history of a distant fall about four years back, which was managed conservatively and he had no fracture, no diagnosis of a fracture at that time.
The X-rays were done, which shows essentially degenerative changes, but there was a suspicion of an odontoid fracture here.
So, CT scan was done, which confirmed the diagnosis of an odontoid non-union. An MRI was done. So, these patients, because they have a neurological deficit, an MRI should be done to find out what’s going on and it showed a stenosis on the upper cervical spine and the area of the nonunion. Because of the fibrous nonunion, there was a pannus which was pinching onto the nerve, onto the spinal cord causing imbalance and upper upper extremity symptoms.
So, it was treated with a stabilization process, surgery C1-C2 fusion, which was able to stop the neurological deficit and gave him some more power back into his hands.