Direct transoral reduction of anteriorly displaced type II odontoid fracture during anterior odontoid screw fixation: Review of literature

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Fig. 1
Preoperative CT cervical spine scans. (A) The coronal CT scan showed a type II odontoid fracture. (B) The sagittal CT scan showed an anteriorly displaced odontoid process (6.2 mm).
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Fig. 2
An intraoperative fluoroscopic image showed the transoral position of the army-navy hand retractor reducing the anteriorly displaced odontoid fracture during screw placement.
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Fig. 3
Early postoperative CT cervical spine scans. (A) The coronal CT scan showed proper placement of the odontoid screw. (B) The sagittal CT scan showed adequate reduction of the displaced odontoid process (2.3 mm).
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Fig. 4
CT cervical spine scans at 3 months postoperatively. (A) The coronal CT scan showed the well-healed odontoid fracture. (B) The sagittal CT scan showed proper screw placement and bony fusion.

Table 1

Transoral manipulation techniques for reduction of displaced type II odontoid fractures in literature

Study	Description of odontoid fracture	Technique of transoral reduction
Elias et al,¹¹ 2006	Ventrally displaced type II odontoid fracture	Continuous transoral digital pressure until odontoid screw placement could be achieved
Ben-Galim and Reitman,¹³ 2008	Anteriorly displaced type II odontoid fracture (1 cm), extended obliquel through upper body of C2	Direct oropharyngeal pressure with padded laryngoscope blade
Piedra et al,¹² 2009	Locked anteriorly displaced type II odontoid fracture	Transoral digital pressure to oropharynx while supporting spinous process of C2