Lateral C1-C2 dislocation complicating a type II odontoid fracture

Area of Science:

• Orthopedics
• Neurosurgery
• Trauma Surgery

Background:

• Cervical spine injuries require precise diagnosis and management.
• Atlantoaxial joint injuries, particularly dislocations, are rare and complex.
• Odontoid fractures are common in the elderly and associated with significant morbidity.

Observation:

• A 63-year-old female presented with a complex C1-C2 lateral dislocation and displaced Type II odontoid fracture after a motor vehicle accident.
• Radiological findings included atlantoaxial joint lateral dislocation, Type II odontoid fracture, C1 lateral mass fracture, and C2 superior articular facet fracture.
• The patient exhibited myelopathy, and closed halo traction was ineffective in reducing the dislocation.

Findings:

• Surgical posterior open reduction and segmental C1-C2 instrumentation and fusion were performed due to the irreducible nature of the dislocation.
• The C1-C2 articulation was successfully reduced during surgery.
• Post-operative bony fusion was achieved, leading to the resolution of all neurological symptoms and signs.

Implications:

• This case represents the first reported instance of a C1-C2 lateral dislocation combined with a displaced Type II odontoid fracture.
• The findings highlight the importance of surgical intervention for irreducible atlantoaxial dislocations.
• This unique injury pattern expands the understanding of complex cervical spine trauma and its management.