PMC6763670_01
Coronal and sagittal computed tomography images of the cervical spine, demonstrating type II odontoid fracture.
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F1
Initial trauma workup demonstrated that the patient had sustained a type II odontoid fracture [Figure 1].
Sagittal immediate post-anterior odontoid screw fixation computed tomography images of the cervical spine, demonstrating near anatomic correction of the patient's type II odontoid fracture with a lag screw.
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F2
He tolerated the procedure well and postoperative imaging demonstrated near anatomic correction of the fracture with satisfactory placement of the lag screw [Figures 2 and 3].
Coronal immediate post-anterior odontoid screw fixation computed tomography images of the cervical spine, demonstrating near anatomic correction of the patient's type II odontoid fracture with a lag screw.
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F3
He tolerated the procedure well and postoperative imaging demonstrated near anatomic correction of the fracture with satisfactory placement of the lag screw [Figures 2 and 3].
Sagittal and coronal computed tomography images of the cervical spine 7 months after anterior odontoid screw fixation demonstrating upward migration of the patient's odontoid screw.
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F4
Unfortunately, the patient was subsequently lost to follow up and he presented 7 months later for a routine outpatient CT of the cervical spine, which demonstrated upward migration of the screw into the intracranial cavity abutting the medulla [Figure 4], with CT angiography of the neck also demonstrating the screw lying between the two vertebral arteries [Figure 5].
Axial computed tomography angiography sequence of the neck 7 months after anterior odontoid screw fixation demonstrating the odontoid screw (thick arrow) marginating the left vertebral artery (thin arrow).
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F5
Unfortunately, the patient was subsequently lost to follow up and he presented 7 months later for a routine outpatient CT of the cervical spine, which demonstrated upward migration of the screw into the intracranial cavity abutting the medulla [Figure 4], with CT angiography of the neck also demonstrating the screw lying between the two vertebral arteries [Figure 5].
Sagittal magnetic resonance imaging sequences of the cervical spine demonstrating the odontoid screw lying within the ventral cervicomedullary junction.
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F6
The patient had also obtained a magnetic resonance imaging of the cervical spine which demonstrated the odontoid screw lying within close proximity to the ventral cervicomedullary junction, marginating the left vertebral artery [Figures 6 and 7].
Axial magnetic resonance imaging sequences of the cervical spine demonstrating the odontoid screw lying within the ventral cervicomedullary junction.
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F7
The patient had also obtained a magnetic resonance imaging of the cervical spine which demonstrated the odontoid screw lying within close proximity to the ventral cervicomedullary junction, marginating the left vertebral artery [Figures 6 and 7].
Sagittal computed tomography images of the cervical spine demonstrating subsequent removal of the odontoid screw with C1-4 posterior cervical instrumented fusion.
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F8
He was subsequently taken for an anterior removal of the odontoid screw with posterior open treatment and reduction, C1-4 posterolateral arthrodesis and instrumented fusion, and Brooks sublaminar wire placement of C1-2 posterior instrumentation [Figure 8].