Posterior-Only Approach for Management of Complete Posterior Displaced Type II Odontoid Fracture.

Abstract

Background: Odontoid fracture (OF) is one of the most common spinal fractures. Type II in D'Alonzo's classification is still the most common and should be considered unstable unless proven otherwise. Thus, surgical stabilization has received significant attention. Although posterior displacement is common in type II OF, complete displacement is extremely rare, and very few reports are available in the literature. Case Presentation: We report the case of a 60-year-old man with acute type II OF with complete posterior displacement and myelopathy. The patient was managed utilizing a posterior-only single approach for reduction and stabilization. Conclusion: Posterior displacement of type II OF has been traditionally managed with close reduction and anterior or posterior stabilization. Closed reduction in cases of complete posterior displacement carries a significant risk of neurologic deterioration. Anterior, combined, and posterior approaches have been taken for this condition. The posterior-only approach in experienced hands has the least mortality and morbidity with at least the same neurologic and fusion outcomes.