Fracture of the odontoid process.

A review of 26 cases of odontoid fractures has been carried out. Late diagnosis and consequent delay in treatment were found to be important causes of non-union. Myelopathy in odontoid fractures is of two types. One type is that present immediately after injury, while the other is delayed. In treatment of long-standing cases, only fusion without posterior decompression should be done. If the latter procedure is carried out, it can produce medullospinal haematomyelia with respiratory arrest and tetraplegia. In the performance of atlanto-axial fusion, the technique of bone grafting and the use of thick wires need emphasis.