European Spine Journal

, Volume 27, Supplement 3, pp 292–297 | Cite as

Anterior submandibular retropharyngeal odontoid osteotomy and posterior atlantoaxial fusion for irreducible atlantoaxial dislocation associated with odontoid fracture malunion

  • Cheng Li
  • Jingzhu Duan
  • Lei LiEmail author
Case Report



To report a case of complex odontoid fracture malunion accompanied by atlantoaxial dislocation which was treated with a new surgical approach.


A 53-year-old female was admitted due to progressive symptoms with a stiff limp and unsteady gait. Preoperative examination, diagnostic radiography, computed tomography, and magnetic resonance imaging were performed following admission. The examinations showed odontoid fracture malunion, an old right axial zygapophyseal fracture, atlantoaxial dislocation, and spinal cord injury. Anterior submandibular retropharyngeal odontoid osteotomy and posterior atlantoaxial fusion were then performed.


Good reduction of the atlantoaxial dislocation was gained. The cervical spinal cord compression was significantly relieved and neurological function was also significantly improved.


Anterior submandibular retropharyngeal odontoid osteotomy and posterior atlantoaxial fusion fixation is an effective method for treating IAAD associated with odontoid fracture malunion, it avoids the adverse effects of anterior transoral odontoid osteotomy and provides a new option for the treatment of odontoid fracture malunion associated with atlantoaxial dislocation.


Anterior Odontoid osteotomy Atlantoaxial dislocation Odontoid fracture Malunion 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no actual or potential conflicts of interest.


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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.Department of OrthopaedicsShengjing Hospital of China Medical UniversityShenyangChina

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