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European Spine Journal

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01-11-2012 | Grand Rounds

Temporary occipito-cervical stabilization of a unilateral occipital condyle fracture

Authors: Klaus John Schnake, Andreas Pingel, Matti Scholz, Frank Kandziora

Published in: European Spine Journal | Issue 11/2012

Abstract

Introduction

Injuries of the occipital condyles are rare. While the majority of occipital condyle fractures can be treated conservatively, surgery is recommended in craniocervical misalignment and instability. Open reduction and temporary occipito-cervical stabilization might be an alternative to fusion or halo treatment.

Materials and methods

This Grand Round case presentation describes temporary C0–C3 stabilization in a 29-year-old man who was involved in a car accident. Radiological examination revealed a rotational burst fracture (type AO C3.1) of C7, and a slight displaced right occipital condyle fracture (Anderson/Montesano type III) with rotational misalignment of the C0–C2 complex.

Results

The C7 fracture was stabilized and fused from anterior and posterior. The occipital condyle fracture was reduced and temporarily stabilized from C0–C3 from posterior. Bony healing occurred after 6 months and consequently the internal fixator was removed to preserve upper cervical mobility.

Magerl F, Aebi M, Gertzbein SD, Harms J, Nazarian S (1994) A comprehensive classification of thoracic and lumbar injuries. Eur Spine J 3:184–201PubMedCrossRef

Reinhold M, Blauth M, Rosiek R, Knop C (2006) Lower cervical spine trauma. Classification and operative treatment. Unfallchirurg 106:471–482

Anderson PA, Montesano PX (1988) Morphology and treatment of occipital condyle fractures. Spine (Phila Pa 1976) 13:721–736CrossRef

Tuli S, Tator CH, Fehlings MG, Mackay M (1997) Occipital condyle fractures. Neurosurgery 41:368–377PubMedCrossRef

Mueller FJ, Fuechtmeier B, Kinner B, Rosskopf M, Neumann C, Nerlich M, Englert C (2012) Occipital condyle fractures. Prospective follow-up of 31 cases within 5 years at a level 1 trauma centre. Eur Spine J 21:289–294PubMedCrossRef

Maserati M, Stephens B, Zohny Z, Lee JY, Kanter AS, Spiro RM, Okonkwo DO (2009) Occipital condyle fractures: clinical decision rule and surgical management. J Neurosurg Spine 11:388–395PubMedCrossRef

Caroli E, Rocchi G, Orlando ER, Delfini R (2005) Occipital condyle fractures: report of five cases and literature review. Eur Spine J 14:487–492PubMedCrossRef

Wassenberg J, Bartlett RJ (1995) Occipital condyle fractures diagnosed by high-definition CT and coronal reconstructions. Neuroradiology 37:370–373CrossRef

Bozboga M, Unal F, Hepgul K, Izgi N, Turantan MI, Turker K (1992) Fracture of the occipital condyle. Case report. Spine (Phila Pa 1976) 17:1119–1121CrossRef

10.

Vaccaro AR, Lim MR, Lee JY (2005) Indications for surgery and stabilization techniques of the occipito-cervical junction. Injury 36(Suppl 2):B44–B53PubMedCrossRef

11.

Hanson JA, Deliganis AV, Baxter AB, Cohen WA, Linnau KF, Wilson AJ, Mann FA (2002) Radiologic and clinical spectrum of occipital condyle fractures: retrospective review of 107 consecutive fractures in 95 patients. Am J Roentgenol 178(5):1261–1268

12.

Pang D, Nemzek WR, Zovickian J (2007) Atlanto-occipital dislocation: part 1—normal occipital condyle-C1 interval in 89 children. Neurosurgery 61(3):514–521PubMedCrossRef

13.

Karam YR, Traynelis VC (2010) Occipital condyle fractures. Neurosurgery 66:56–59PubMedCrossRef

14.

Malham GM, Ackland HM, Jones R, Williamson OD, Varma DK (2009) Occipital condyle fractures: incidence and clinical follow-up at a level 1 trauma centre. Emerg Radiol 16:291–297PubMedCrossRef

Title: Temporary occipito-cervical stabilization of a unilateral occipital condyle fracture
Authors: Klaus John Schnake
Andreas Pingel
Matti Scholz
Frank Kandziora
Publication date: 01-11-2012
Publisher: Springer-Verlag
Published in: European Spine Journal / Issue 11/2012
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-012-2275-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Temporary occipito-cervical stabilization of a unilateral occipital condyle fracture

Abstract

Introduction

Materials and methods

Results

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

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