J Korean Neurosurg Soc.  2014 Apr;55(4):212-214. 10.3340/jkns.2014.55.4.212.

Odontoid Synchondrosis Fracture Treated by C1-2 Polyaxial Screw-Rod Fixation

• Muthukumar N

• KMID: 2191095
• DOI: http://doi.org/10.3340/jkns.2014.55.4.212

Abstract

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 successful outcome and discuss the possible reasons for occurrence of odontoid synchondrosis fracture in this older child as well as the indications for surgery in this condition.

Keyword

Odontoid fracture; Synchondrosis; Trauma; Axis; Cervical fusion

MeSH Terms

Axis, Cervical Vertebra
Child
Humans
Immobilization

Figure

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  Fig. 1 Sagittal reconstructions of CT cervical spine showing odontoid synchondrosis fracture with posterior displacement of the fragment.

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  Fig. 2 Sagittal T1 weighted sequence (A) and sagittal T2 weighted sequence (B) showing odontoid synchondrosis fracture with intramedullary signal changes.

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  Fig. 3 Intraoperative photograph showing the C1 lateral mass screws (single arrows) and C2 pars screws (double arrows).

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  Fig. 4 Postoperative skull radiograph (A) anteroposterior view and (B) lateral view showing the screw rod construct in situ.

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  Fig. 5 Postoperative CT scan showing (A) coronal reconstructed CT with the screws in proper position in C1 and C2 and, (B) sagittal reconstructed CT showing the screws in position in C1 and C2.

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  Fig. 6 Postoperative clinical photograph of the patient 6 months after surgery showing good clinical improvement.

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