A 30-year-old Pseudo-arthrosis of Type-II Fracture of the Odontoid Process with Intermittent Sub-occipital Discomfort: A Report of An Unusual Case

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Design: A report of an unusual case.<BR>Objective: To describe an unusual case presenting with intermittent sub-occipitalgia due to 30-year-old pseudo-arthrosis of the odontoid process.<BR>Case File: A 55-year-old man was referred to our hospital complaining of intermittent sub-occipitalgia pertaining to Anderson-D'Alonzo type II ununited fracture of the dens. Medical history revealed neck trauma in a serious motorcycle collision 30 years earlier, but no fracture-dislocation of the cervical spine was identified at a local hospital. The patient returned to physically-demanding work as a labourer 10 days after the trauma, and upper neck pain continued with remissions and sometimes worsening. Radiological examination showed pseudo-arthrosis of the odontoid process, with 8 mm anterior subluxation of the dens on neck flexion. Neck discomfort disappeared after posterior reduction and C1-C2 fusion.<BR>Conclusion: A 30-year symptomatic worsening associated with pseudo-arthrosis of Anderson-D'Alonzo type II odontoid fracture is unusual. Awareness of this condition is important to reduce possible morbidity and to provide early treatment.
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