Os odontoideum: case report
Autor(a) principal: | |
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Data de Publicação: | 2012 |
Outros Autores: | , , , , , |
Tipo de documento: | Relatório |
Idioma: | eng |
Título da fonte: | Coluna/Columna |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1808-18512012000400018 |
Resumo: | OBJECTIVE: To report the difficulties in managing a case of os odontoideum. METHODS: Female patient, 12 years old who developed a quadiparesis after minor cervical trauma in October 2005. In the emergency department a congenital cervical anomaly was identified. The patient was placed in a Stryker® frame and, few days later, in a halo bracing. After 3 months, an infection around the pins emerged and the halo vest had to be removed. A severe C1-2 instability persisted and a C1-C2 Gallie procedure was attempted. In the following weeks the bone disappeared and another procedure was attempted in June 2006 - C1 laminectomy and occiput-C3 fusion. In the following months the neurological status of the patient improved and a complete mass of occiput-C3 fusion was observed. RESULTS: We choose a posterior cervical arthrodesis of C1-C2 using the Gallie technique. Since the condition was not resolved we performed a second surgery, C1 laminectomy (determined by SAC of 8, 3 mm in MRI) followed by posterior occiput-C3 fusion. In our case, until now, there is no evidence of axial decompensation, but a more prolonged follow-up is needed. CONCLUSIONS: The treatment of os odontoideum has many considerations but the essential that in the presence of instability and neurological deficit a solid fusion is achieved. In case of failure of posterior atlantoaxial wiring, the occiput-C2 or C3 fusion with rods seems to be an excellent option with a high rate of success, avoiding the need for additional support. |
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Os odontoideum: case reportOdontoid process/surgeryOdontoid process/radiographyCervical vertebraeSpinal injuriesOBJECTIVE: To report the difficulties in managing a case of os odontoideum. METHODS: Female patient, 12 years old who developed a quadiparesis after minor cervical trauma in October 2005. In the emergency department a congenital cervical anomaly was identified. The patient was placed in a Stryker® frame and, few days later, in a halo bracing. After 3 months, an infection around the pins emerged and the halo vest had to be removed. A severe C1-2 instability persisted and a C1-C2 Gallie procedure was attempted. In the following weeks the bone disappeared and another procedure was attempted in June 2006 - C1 laminectomy and occiput-C3 fusion. In the following months the neurological status of the patient improved and a complete mass of occiput-C3 fusion was observed. RESULTS: We choose a posterior cervical arthrodesis of C1-C2 using the Gallie technique. Since the condition was not resolved we performed a second surgery, C1 laminectomy (determined by SAC of 8, 3 mm in MRI) followed by posterior occiput-C3 fusion. In our case, until now, there is no evidence of axial decompensation, but a more prolonged follow-up is needed. CONCLUSIONS: The treatment of os odontoideum has many considerations but the essential that in the presence of instability and neurological deficit a solid fusion is achieved. In case of failure of posterior atlantoaxial wiring, the occiput-C2 or C3 fusion with rods seems to be an excellent option with a high rate of success, avoiding the need for additional support.Sociedade Brasileira de Coluna2012-12-01info:eu-repo/semantics/reportinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1808-18512012000400018Coluna/Columna v.11 n.4 2012reponame:Coluna/Columnainstname:Sociedade Brasileira de Coluna (SBCO)instacron:SBCO10.1590/S1808-18512012000400018info:eu-repo/semantics/openAccessPinho,André RodriguesMoutinho,Vitorino VeludoSilva,Nuno Paulo AlegreteSerdoura,António Francisco MartingoFreitas,Joana Manuel FerreiraPinto,Rui Alexandre PeixotoCabral,Abel Vitorino Trigoeng2013-01-18T00:00:00Zoai:scielo:S1808-18512012000400018Revistahttps://www.revistacoluna.org/ONGhttps://old.scielo.br/oai/scielo-oai.phpcoluna.columna@uol.com.br||revistacoluna@uol.com.br2177-014X1808-1851opendoar:2013-01-18T00:00Coluna/Columna - Sociedade Brasileira de Coluna (SBCO)false |
dc.title.none.fl_str_mv |
Os odontoideum: case report |
title |
Os odontoideum: case report |
spellingShingle |
Os odontoideum: case report Pinho,André Rodrigues Odontoid process/surgery Odontoid process/radiography Cervical vertebrae Spinal injuries |
title_short |
Os odontoideum: case report |
title_full |
Os odontoideum: case report |
title_fullStr |
Os odontoideum: case report |
title_full_unstemmed |
Os odontoideum: case report |
title_sort |
Os odontoideum: case report |
author |
Pinho,André Rodrigues |
author_facet |
Pinho,André Rodrigues Moutinho,Vitorino Veludo Silva,Nuno Paulo Alegrete Serdoura,António Francisco Martingo Freitas,Joana Manuel Ferreira Pinto,Rui Alexandre Peixoto Cabral,Abel Vitorino Trigo |
author_role |
author |
author2 |
Moutinho,Vitorino Veludo Silva,Nuno Paulo Alegrete Serdoura,António Francisco Martingo Freitas,Joana Manuel Ferreira Pinto,Rui Alexandre Peixoto Cabral,Abel Vitorino Trigo |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Pinho,André Rodrigues Moutinho,Vitorino Veludo Silva,Nuno Paulo Alegrete Serdoura,António Francisco Martingo Freitas,Joana Manuel Ferreira Pinto,Rui Alexandre Peixoto Cabral,Abel Vitorino Trigo |
dc.subject.por.fl_str_mv |
Odontoid process/surgery Odontoid process/radiography Cervical vertebrae Spinal injuries |
topic |
Odontoid process/surgery Odontoid process/radiography Cervical vertebrae Spinal injuries |
description |
OBJECTIVE: To report the difficulties in managing a case of os odontoideum. METHODS: Female patient, 12 years old who developed a quadiparesis after minor cervical trauma in October 2005. In the emergency department a congenital cervical anomaly was identified. The patient was placed in a Stryker® frame and, few days later, in a halo bracing. After 3 months, an infection around the pins emerged and the halo vest had to be removed. A severe C1-2 instability persisted and a C1-C2 Gallie procedure was attempted. In the following weeks the bone disappeared and another procedure was attempted in June 2006 - C1 laminectomy and occiput-C3 fusion. In the following months the neurological status of the patient improved and a complete mass of occiput-C3 fusion was observed. RESULTS: We choose a posterior cervical arthrodesis of C1-C2 using the Gallie technique. Since the condition was not resolved we performed a second surgery, C1 laminectomy (determined by SAC of 8, 3 mm in MRI) followed by posterior occiput-C3 fusion. In our case, until now, there is no evidence of axial decompensation, but a more prolonged follow-up is needed. CONCLUSIONS: The treatment of os odontoideum has many considerations but the essential that in the presence of instability and neurological deficit a solid fusion is achieved. In case of failure of posterior atlantoaxial wiring, the occiput-C2 or C3 fusion with rods seems to be an excellent option with a high rate of success, avoiding the need for additional support. |
publishDate |
2012 |
dc.date.none.fl_str_mv |
2012-12-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/report |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
report |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1808-18512012000400018 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1808-18512012000400018 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/S1808-18512012000400018 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Coluna |
publisher.none.fl_str_mv |
Sociedade Brasileira de Coluna |
dc.source.none.fl_str_mv |
Coluna/Columna v.11 n.4 2012 reponame:Coluna/Columna instname:Sociedade Brasileira de Coluna (SBCO) instacron:SBCO |
instname_str |
Sociedade Brasileira de Coluna (SBCO) |
instacron_str |
SBCO |
institution |
SBCO |
reponame_str |
Coluna/Columna |
collection |
Coluna/Columna |
repository.name.fl_str_mv |
Coluna/Columna - Sociedade Brasileira de Coluna (SBCO) |
repository.mail.fl_str_mv |
coluna.columna@uol.com.br||revistacoluna@uol.com.br |
_version_ |
1752126614285582336 |