OBJECTIVES: To analyze a series of patients with unstable type III odontoid fractures surgically treated. METHODS: Retrospective analysis of a series of 5 consecutive cases of patients with type III odontoid fractures, who underwent surgical treatment. RESULTS: Three patients were initially treated with halo vest, and underwent surgical fixation in face of pseudarthrosis or failure of the orthosis in maintaining reduction. Two patients underwent primary surgical treatment, one had marked radiological instability in flexion and spinal cord compression and other had neurological compromise. The surgical technique was individualized for each case. There were no major complications. Four patients became asymptomatic and only one patient developed non-disabling neck pain. Computed tomography (CT) showed fracture healing in two cases, the other 3 patients did not undergo CT scan. The mean follow-up was 1.9 years. CONCLUSIONS: As type III fractures of odontoid are not always benign, it is important to individualize their treatment whenever any unusual feature is identified. There are some criteria of instability and indications for surgical treatment for patients with this type of injury.
Spinal injuries; spinal fractures; odontoid process; axis; spine
