Transoral C2 osteotomy for treatment of severe irreducible atlantoaxial dislocation after odontoid fracture: about 3 cases.

OBJECTIVE

To report the outcomes of transoral C2 osteotomy (or partial odontoidectomy) and posterior fixation, regarding efficacy and safety, in patients with severe irreducible atlantoaxial dislocation (IAAD) following odontoid fracture.

METHODS

Transoral C2 osteotomy, soft tissue resection, with or without facet joint release, followed by posterior fixation were performed on 3 patients (2012, 2016, 2023) who were suffering from severe IAAD after an odontoid fracture with spinal cord compression. The radiological and clinical outcomes were then assessed.

RESULTS

All 3 patients had satisfactory release of their spinal cord compression and good reduction of their IAAD. No neurological or vascular complications were reported. No instrumentation failure, radiolucent zone formation around the screws, infection, or recurrence of dislocation were encountered neither. Bony fusion was successfully achieved in every patient.

CONCLUSION

Transoral C2 osteotomy (or partial odontoidectomy), soft tissue resection, with or without facet joint release, followed by posterior fixation is an effective and reliable method to treat severe IAAD after odontoid fractures.