Type II Odontoid Fracture

What is it?

A Type II Odontoid Fracture refers to a specific kind of fracture involving the odontoid process, a bony projection from the second cervical vertebra (C2), commonly known as the axis. This type of fracture occurs at the base of the odontoid process, just above the junction with the body of C2. It is the most common and most clinically significant type among the three classifications of odontoid fractures, due to its high risk of nonunion and potential for spinal cord injury.

Symptoms

The clinical presentation of a Type II Odontoid Fracture can include:

  • Neck Pain: Often severe and localized, exacerbated by movement.
  • Reduced Range of Motion: Limited ability to turn or tilt the head due to pain and swelling.
  • Neurological Deficits: Though less common, some patients may experience symptoms indicative of spinal cord compression, such as numbness, weakness, or altered sensation in the extremities.

Diagnosis

Diagnosis of a Type II Odontoid Fracture involves:

  • Medical History and Physical Examination: Assessment of symptoms, mechanism of injury, and a thorough neurological examination to evaluate for deficits.
  • Imaging Studies:
  • X-rays of the Cervical Spine
  • Computed Tomography (CT) Scan
  • Magnetic Resonance Imaging (MRI):

Treatment

The treatment of Type II Odontoid Fractures varies based on factors such as the patient’s age, overall health, degree of fracture displacement, and bone quality:

  • Conservative Management: Involves immobilization with a cervical collar or halo vest. This approach is more common in patients with non-displaced fractures or in those where surgery presents significant risks.
  • Surgical Intervention: Indicated in cases of unstable or significantly displaced fractures, or if there is evidence of nonunion. Surgical options include:
  • Anterior Odontoid Screw Fixation: Involves placing a screw directly into the odontoid process to stabilize the fracture.
  • Posterior C1-C2 Fusion: Used if anterior screw fixation is not feasible, especially in cases with poor bone quality or significant displacement.