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Os odontoideum.

M Di Silvestre¹, S Guizzardi, G Gargiulo

¹Centro Scoliosi, Istituto Ortopedico Rizzoli, Bologna.

La Chirurgia Degli Organi Di Movimento

|April 1, 1991

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This study shows that a three-stage surgical protocol effectively treats atlo-axial instability caused by os odontoideum. Patients experienced pain relief and neurological recovery, preventing long-term complications.

Area of Science:

Orthopedic Surgery
Neurosurgery
Spinal Disorders

Background:

Atlo-axial instability secondary to os odontoideum presents with persistent cervical pain and neurological deficits.
Early and severe neurological deficits, including spastic tetraparesis, can occur.

Purpose of the Study:

To evaluate the efficacy of a specific three-stage surgical treatment protocol for atlo-axial instability due to os odontoideum.
To assess outcomes regarding pain regression, neurological recovery, and fusion consolidation.

Main Methods:

Eight patients with atlo-axial instability underwent a protocol including preoperative halo-plaster reduction, posterior C1-C2 vertebral fusion, and postoperative halo-plaster immobilization.
Surgical fusion was limited to C1-C2 in six patients and extended to the occiput in two.

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Main Results:

Complete fusion consolidation was achieved in all patients after an average follow-up of over 4 years.
All patients experienced total regression of cervical pain.
Significant neurological recovery was observed, particularly in those with severe preoperative spastic tetraparesis.

Conclusions:

The described three-stage surgical protocol is a reliable and effective treatment for atlo-axial instability secondary to os odontoideum.
This approach can prevent chronic instability and severe neurological sequelae, and promote recovery even in advanced cases.