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Neglected Posttraumatic Atlantoaxial Spondyloptosis with Type 2 Odontoid Fracture: A Case Report
Kaustubh Ahuja1, Pankaj Kandwal1, Sanny Singh1
1Department of Orthopaedic Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Introduction:
In atlantoaxial context, spondyloptosis has been defined as a situation when both the inferior facets of atlas are fixed anterior to the superior facets of axis. Such an injury scenario is a rare presentation with a few reported cases in available literature.
Case Report:
We present a case of post-traumatic anterior atlantoaxial dislocation or spondyloptosis associated with a Type 2 odontoid fracture in an adult patient who presented to us 3 months after injury. After failed attempts of closed reduction with traction, open reduction and posterior instrumentation with fusion were done using joint remodeling technique. 6-month follow-up showed completely reduced facet joints with near complete fusion.
Conclusion:
Long-standing complete C1-C2 dislocations pose a challenge for a surgeon because of the associated difficulty in joint reduction. Joint remodeling and manipulation have antiquated transoral odontoidectomy as excellent results have been achieved by direct posterior approach.
