{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T18:28:01Z","timestamp":1746124081358},"reference-count":10,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"Background:<\/jats:title>Type 2 odontoid fractures are associated with a high rate of nonunion without surgical treatment. If neglected, they may become fixed in an abnormal position, causing progressive myelopathy. Conventionally, odontoidectomy or transoral release is performed to relieve symptoms in such cases. Here, were report our experience with a transcervical approach for odontoid release (i.e., of a chronically fractured dens) followed by a posterior C1\u2013C2 fusion.<\/jats:p><\/jats:sec>Methods:<\/jats:title>The 11 patients (2017\u20132021) retrospectively included; in this study, all had a history of remote trauma and the radiological appearance of an old odontoid fracture that was displaced and could not be reduced with traction. There were eight males and three females who averaged 52.6 years of age.<\/jats:p><\/jats:sec>Results:<\/jats:title>All 11 patients underwent anterior retropharyngeal release with a C4\u2013C5 level incision followed by a posterior C1\u2013C2 fusion. The mean Japanese orthopedic association on presentation was 9.9 \u00b1 2.7 which improved to 13.8 \u00b1 2.7 on final follow-up (P<\/jats:italic>< 0.01). Patients were followed an average of 9.6 months \u00b1 4.4 (mean \u00b1 SD) postoperatively during which time they all clinically improved.<\/jats:p><\/jats:sec>Conclusion:<\/jats:title>Anterior release through a retropharyngeal approach coupled with posterior C1\u2013C2 instrumentation proved to be an effective alternative to the traditional transoral approach to treat a chronic malunited odontoid fracture.<\/jats:p><\/jats:sec>","DOI":"10.25259\/sni_237_2022","type":"journal-article","created":{"date-parts":[[2022,4,8]],"date-time":"2022-04-08T07:31:19Z","timestamp":1649403079000},"page":"132","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Anterior transcervical release with posterior atlantoaxial fixation for neglected malunited type II odontoid fractures"],"prefix":"10.25259","volume":"13","author":[{"given":"Riaz Ur","family":"Rehman","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Lady Reading Hospital,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Shaheer","family":"Akhtar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Lady Reading Hospital,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amna","family":"Bibi","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Hayatabad Medical Complex, Peshawar, Pakistan."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2022,4,8]]},"reference":[{"key":"10.25259\/SNI_237_2022\/ref-1","doi-asserted-by":"crossref","first-page":"349","DOI":"10.4184\/asj.2016.10.2.349","article-title":"Irreducible atlanto-axial dislocation in neglected odontoid fracture treated with single stage anterior release and posterior instrumented fusion","volume":"10","author":"Aggarwal","year":"2016","journal-title":"Asian Spine J"},{"key":"10.25259\/SNI_237_2022\/ref-2","doi-asserted-by":"crossref","first-page":"1843","DOI":"10.1097\/00007632-199708150-00009","article-title":"Acute axis fractures. Analysis of management and outcome in 340 consecutive cases","volume":"22","author":"Greene","year":"1997","journal-title":"Spine"},{"key":"10.25259\/SNI_237_2022\/ref-3","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1111\/j.1757-7861.2009.00049.x","article-title":"One-stage anterior release and reduction with posterior fusion for treatment of irreducible atlantoaxial dislocation","volume":"1","author":"Hao","year":"2009","journal-title":"Orthop Surg"},{"key":"10.25259\/SNI_237_2022\/ref-4","first-page":"1004","article-title":"Surgical management of remote, isolated type II odontoid fractures with atlantoaxial dislocation causing cervical compressive myelopathy","volume":"56","author":"Kirankumar","year":"2005","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_237_2022\/ref-5","first-page":"1","article-title":"Surgical treatment of neglected C2 odontoid process fracture with anterior atlantoaxial dislocation","volume":"35","author":"Klimov","year":"2020","journal-title":"Br J Neurosurg"},{"key":"10.25259\/SNI_237_2022\/ref-6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/2309499019870465","article-title":"Treatment of irreducible atlantoaxial dislocation using one-stage retropharyngeal release and posterior reduction","volume":"27","author":"Ren","year":"2019","journal-title":"J Orthop Surg (Hong Kong)"},{"key":"10.25259\/SNI_237_2022\/ref-7","doi-asserted-by":"crossref","first-page":"231948","DOI":"10.1155\/2014\/231948","article-title":"Systematic review on surgical and nonsurgical treatment of type II odontoid fractures in the elderly","volume":"2014","author":"Robinson","year":"2014","journal-title":"BioMed Res Int"},{"key":"10.25259\/SNI_237_2022\/ref-8","doi-asserted-by":"crossref","first-page":"E306","DOI":"10.1097\/01.brs.0000217686.80327.e4","article-title":"Open reduction of irreducible atlantoaxial dislocation by transoral anterior atlantoaxial release and posterior internal fixation","volume":"31","author":"Wang","year":"2006","journal-title":"Spine"},{"key":"10.25259\/SNI_237_2022\/ref-9","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1097\/BSD.0b013e3181988bf5","article-title":"Microendoscopic anterior approach for irreducible atlantoaxial dislocation: Surgical techniques and preliminary results","volume":"23","author":"Wu","year":"2010","journal-title":"J Spinal Disord Tech"},{"key":"10.25259\/SNI_237_2022\/ref-10","doi-asserted-by":"crossref","first-page":"190","DOI":"10.4103\/ortho.IJOrtho_251_16","article-title":"Sagittal atlantoaxial joint inclination and reduction index values for diagnosis and treatment of irreducible atlantoaxial dislocation","volume":"52","author":"Yuan","year":"2018","journal-title":"Indian J Orthop"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/anterior-transcervical-release-with-posterior-atlantoaxial-fixation-for-neglected-malunited-type-ii-odontoid-fractures\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/anterior-transcervical-release-with-posterior-atlantoaxial-fixation-for-neglected-malunited-type-ii-odontoid-fractures\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,19]],"date-time":"2023-11-19T20:11:01Z","timestamp":1700424661000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/anterior-transcervical-release-with-posterior-atlantoaxial-fixation-for-neglected-malunited-type-ii-odontoid-fractures\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,8]]},"references-count":10,"alternative-id":["10.25259\/SNI_237_2022"],"URL":"https:\/\/doi.org\/10.25259\/sni_237_2022","relation":{},"ISSN":["2152-7806"],"issn-type":[{"value":"2152-7806","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,8]]},"article-number":"132"}}