Article Figures & Data
Figures
- Figure 1
Radiological data of a 61-year-old male patient (patient 1). (A) Preoperative x-ray. (B) A CT scan showed a type I C1 fracture. (C) Coronal reconstruction of a CT imageshowed the avulsions involving the tubercle for insertion of TAL on the C1 lateral mass (red arrow). (D) Sagittal reconstruction of a CT image showed type IIB odontoid fracture. (E) MRI showed that the avulsions involved the tubercle for insertion of TAL on the C1 lateral mass. (F) Postoperative x-ray. (G and H) The flexion-extension dynamic lateral cervical radiograph showed stable C1–C2 at 21-month follow-up. (I) Sagittal reconstruction of a CT image showed that the odontoid fracture achieved bone healing at 21-month follow-up. (J) A CT image showed that the C1 fracture achieved almost bone healing at 21-month follow-up. CT, computed tomography; MRI, magnetic resonance imaging; post-, postoperative; pre-, preoperative; TAL, transverse atlantal ligament.
- Figure 2
Radiological data of a 63-year-old male patient (patient 2). (A) Preoperative x-ray. (B) A CT image showed a type II C1 fracture. (C) Coronal reconstruction of a CT image showed the avulsions involving the tubercle for insertion of TAL on the C1 lateral mass (red arrow). (D) Sagittal reconstruction of a CT image showed type IIB odontoid fracture. (E) MRI showed that the TAL was intact. (F) Postoperative x-ray. (G and H) The flexion-extension dynamic lateral cervical radiograph showed stable C1–C2 at 25-month follow-up. (I) Sagittal reconstruction of a CT image showed that the odontoid fracture achieved bone healing at 25-month follow-up. (J) A CT scan showed that the C1 fracture achieved bone healing at 25-month follow-up. CT, computed tomography; MRI, magnetic resonance imaging; post-, postoperative; pre-, preoperative; TAL, transverse atlantal ligament.
- Figure 3
General images of the range of motion of the cervical spine for patient 1 at 21-month follow-up. (A) Cervical flexion. (B) Cervical extension. (C) Right cervical rotation. (D) Left cervical rotation.
- Figure 4
General images of the range of motion of the cervical spine for patient 2 at 25-month follow-up. (A) Cervical flexion. (B) Cervical extension. (C) Right cervical rotation. (D) Left cervical rotation.
- Figure 5
The rotation angle of C1–C2 of patient2 at 25-month follow-up. The C1–C2 rotation is equal to the C1 rotation minus the C2 rotation.
Tables
- Table 1
Case reports and case series of C1 burst fracture combined with type II odontoid fracture described in the literature.
Author Cases Age, y Treatment Strategies Follow-Up,
moGleizes et al4 8 44.8 A modified Gallie arthrodesis, posterior C1–C2 screw fixation, C2 pedicle screw 13.6 Guiot and Fessler5 9 57.8 Posterior C1–C2 transarticular screw+ Songer cable, anterior/posterior C1–C2 transarticular screw, or/and odontoid screw 28.5 Dickman et al6 10 44 External immobilization, C1–C2 wiring/fusion 41 Liu et al7 3 38, 18, and 56 Dontoid screw fixation combined with atlantoaxial pedicle screw fixation surgery without fusion, plaster immobilization 9, 1, and 30 Zhao et al8 21 52.4 Halo vest, posterior C–C2 pedicle screw fixation, occipital cervical fusion 23.9 Josten et al9 23 84.6 Anterior odontoid and transarticular C1/C2 screw fixation 12 Malagelada et al10 1 92 Rigid collar 1 Biakto et al11 1 17 Occipital cervical fusion 2 Note: Age and follow-up are given as mean except for Liu et al, Malagelada et al, and Biakto et al, which are give as number.
Patient Visual Analog Scale Neck Disability Index Left Rotation Right Rotation Total Rotation Complication Pre Post Final Follow-Up Pre Post Final Follow-Up Patient 1 8.1 4.3 1.6 42.7 26.9 10.8 19° 14° 33° None Patient 2 7.8 3.9 1.9 41.6 27.4 10.3 29° 20° 49° None Abbreviations: Post, postoperative; Pre, preoperative.
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