{"id":"4a349267-e51f-4350-80b9-534baaa08c32","slug":"case-report-challenging-post-traumatic-pseudoarthrosis-of-c2-odontoid-fracture-and-extreme-c1-c2-subluxation","title":"Case report: Challenging post-traumatic pseudoarthrosis of C2 odontoid fracture and extreme C1-C2 subluxation","authors":["Pedro Gonçalo Abreu","Clara Romero","Jose Artur Bastos Lourenço","Lia Pappamikail","Miguel Brito","Pedro Teles","Joaquim Correia"],"abstract":"Background: Type II C2 odontoid fractures are common traumatic cervical spine lesions and have the highest risk of non-union without fusion. Pseudoarthrosis may lead to extreme anatomic deformation, and poor clinical outcomes. A 50-year-old male, following a traumatic C2 dens fracture treated when the patient was 44 years of age, newly presented at age 50 with pseudoarthrosis and severe C1-C2 subluxation that required a secondary fusion using a three-dimensional (3D) printed model for appropriate surgical planning. Case Description: A 44-year-old male underwent a C1 posterior arch osteotomy to treat cervical myelopathy after a type 2 odontoid fracture. Now at age 50, he newly presented with recurrent myelopathy, and marked cord compression due to a C2 odontoid-dens pseudoarthrosis, and extreme C1 subluxation over C2. A 3D model of the patients’ cervical-spine anatomy was created for surgical planning and led to an anterior C1-C2 freeing of the pseudoarthrosis, followed by a posterior C0-C1 decompression, deformity reduction, C0, C2 laminar, and C3/4 trans-articular arthrodesis. Six months postoperatively, the patient improved from a pre-operative mJOA score of 5 to a postoperative mJOA score of 14. Conclusion: A 3D model was successfully utilized to plan a secondary 360° fusion for a pseudoarthrosis diagnosed 6 years after an original C-C2type II odontoid fusion in a now 50-year-old male.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/4a349267-e51f-4350-80b9-534baaa08c32/featured/hero-1781561494194.png","publishDate":"2022-04-08T00:00:00.000Z","doi":"10.25259/SNI_10_2022","categories":["Spine","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2022/04/11512/SNI-13-137.pdf"}