• S Fuentes, P Bouillot, O Palombi, A Ducolombier, and M Desgeorges .
• Department of Neurosurgery, La Timone University Hospital Center, Marseille, France. sfuentes@ap-hm.fr
• Spine. 2001 Apr 1; 26 (7): 830-4.

Study DesignA case of traumatic rotatory dislocation associated with odontoid fracture is reported.ObjectivesTo report a rare case of traumatic rotatory dislocation associated with odontoid fracture, and to discuss the mechanism underlying spinal instability and management.Summary Of Background DataThis case is a cross between traumatic rotatory fixation and atlantoaxial rotatory dislocation. Classification of rotatory subluxation change after osteosynthesis of the odontoid process was undertaken.MethodsA 24-year-old man sustained head and cervical injury after jumping. A Type 2 odontoid fracture without displacement was noted.ResultsWithout further traumatic event, 1 month after injury, computed tomography scan showed posterior displacement of the odontoid fracture and Type 4 or B atlantoaxial rotatory luxation. After surgical fixation and reduction of the odontoid fracture, the rotatory subluxation classification changed and became Type 1 or A. Posterior C1-C2 arthrodesis was performed. The patient wore a Philadelphia cervical collar for 3 months and underwent physiotherapy.ConclusionsAs the pivot of rotatory subluxation changed after odontoid process osteosynthesis, posterior C1-C2 arthrodesis was performed. The patient probably could have been treated in a single-stage procedure using posterior C1-C2 transarticular fixation with bicortical interspinous graft.

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