Transverse atlantal ligament disruption associated with odontoid fractures. Spine (Phila Pa 1976) 1994 Oct 15;19(20):2307-14
Date
10/15/1994Pubmed ID
7846576DOI
10.1097/00007632-199410150-00010Scopus ID
2-s2.0-0028081469 (requires institutional sign-in at Scopus site) 73 CitationsAbstract
OBJECTIVES: The authors evaluated transverse atlantal ligament integrity in patients with fractures of the odontoid process of the axis.
SUMMARY OF BACKGROUND DATA: Injuries of the transverse atlantal ligament can result in atlantoaxial instability after fractures of the atlas or axis, even if osseous healing occurs.
METHODS: The clinical histories and follow-up examinations and radiographic data of 30 patients with odontoid fractures were reviewed, using a combination of magnetic resonance (MR) imaging, thin-cut computed tomography (CT), and plain radiographs to evaluate osseous and ligamentous injuries.
RESULTS AND CONCLUSIONS: Osteoperiosteal ligamentous avulsion injuries were identified on MR imaging in three patients and were associated with acute and delayed instability and nonunion. The combination of MR imaging, CT, and plain radiographs is useful in evaluating unstable odontoid fractures to facilitate rational treatment planning. Odontoid fractures with transverse ligament injuries should be considered for early surgical stabilization because this combination of injuries is unlikely to heal nonoperatively. Anterior odontoid screw fixation should be avoided when the ligament is injured.
Author List
Greene KA, Dickman CA, Marciano FF, Drabier J, Drayer BP, Sonntag VKAuthor
Karl A. Greene MD Adjunct Assistant Professor in the Neurosurgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Aged, 80 and over
Braces
Cervical Atlas
Female
Fractures, Bone
Humans
Ligaments
Magnetic Resonance Imaging
Male
Middle Aged
Odontoid Process
Tomography, X-Ray Computed
