Odontoid fractures are among the most common injuries at the craniocervical junction and account for nearly one in six cervical spine fractures. Keywords: Hypertrophic pseudoarthrosis, myelopathy, nonunion, odontoid fracture, transoral surgery Such cases require anterior transoral decompression, posterior cervical decompression, and instrumented fusions. At follow-up, the cervical myelopathy has improved to near normalcy (mJOA 17) with no evidence or implant-related complication.Ĭonclusion:Rarely, nonunion of Type II odontoid fractures may be hypertrophic where both instability and compression cause neurological morbidity. The patient underwent anterior transoral decompression, followed by posterior occipitothoracic decompression and instrumented fusion. ![]() Spinal imaging studies revealed hypertrophic nonunion and craniocervical kyphotic deformity with significant subaxial stenosis and segmental kyphosis. Her history was positive for a Type II odontoid fracture managed conservatively and lost to follow-up for 25 years. We present a case and review literature around this entity.Ĭase Description:A 68-year-old female presented with rapidly progressive cervical myelopathy (from normal to moderate myelopathy modified Japanese Orthopedic Association 13) over 3 months. ![]() ![]() Rarely, the hypertrophic nonunion requires both anterior transoral decompression and posterior decompression with instrumented fusion. Background:Complications of nonunited Type II odontoid fractures can range from neck pain to progressive neurological deficit from cervical myelopathy.
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