CRANIOCERVICAL COMPRESSIVE MYELOPATHY ASSOCIATED WITH TYPE II ODONTOID FRACTURE-DISLOCATION AND ATLANTOAXIAL INSTABILITY: A CASE REPORT
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Abstract
Relevance. Traumatic injuries of the craniocervical junction represent high-risk conditions in neurosurgical practice because this region contains the upper cervical spinal cord, neural pathways functionally related to the medulla oblongata, vertebral arteries, and a complex osteoligamentous system responsible for atlantoaxial stability. Type II odontoid fractures according to the Anderson–D’Alonzo classification are clinically significant due to their increased risk of nonunion, instability, secondary displacement, and spinal cord compression. Case presentation. A patient was admitted to the neurosurgical department after falling from a height. The main complaints included severe cervical pain, bilateral radiation of pain to the upper limbs, restricted movements in the arms and legs, numbness, cold sensation in the extremities, sleep disturbance due to pain, and general weakness. Neurological examination revealed tetraparesis, Frankel grade C, McCormick grade 3, and severe pain scored as 8 points on the visual analogue scale. Instrumental diagnostics demonstrated pathological fracture-dislocation of the C2 odontoid process with partial osteolysis and displacement, C1 lateral listhesis, C1–C2 instability, pronounced spinal canal stenosis, and spinal cord compression at the craniocervical junction. The patient underwent C1–C2 transpedicular fixation, reduction, stabilization, and decompression. Conclusion. This clinical case highlights the importance of early CT/MRI assessment, standardized neurological grading, restoration of atlantoaxial stability, and timely spinal cord decompression in traumatic craniocervical junction injuries.
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