Os Odontoideum

Publication Date: March 1, 2013
Last Updated: March 14, 2022

RECOMMENDATIONS

(All are Level III)

Diagnosis

Plain radiographs of the cervical spine (anterior- posterior, open mouth-odontoid, and lateral) and plain dynamic lateral radiographs performed in flexion and extension are recommended to diagnose and evaluate os odontoideum, with or without tomography (computerized or plain) and/or magnetic resonance imaging of the craniocervical junction.
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Management

Clinical and radiographic surveillance or posterior C1-C2 internal fixation and fusion are recommended for patients with os odontoideum without symptoms or neurological signs.
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Posterior C1-C2 internal fixation and fusion are recommended for patients with os odontoideum with neurological symptoms, signs, or C1-C2 instability.
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Postoperative halo immobilization is recommended as an adjunct to posterior internal fixation and fusion unless rigid C1-C2 internal fixation is accomplished.
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Occipital-cervical internal fixation and fusion with or without C1 laminectomy is recommended in patients with os odontoideum who have irreducible dorsal cervicomedullary compression and/or evidence of associated occipital- atlantal instability.
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Ventral decompression should be considered in patients with os odontoideum who have irreducible ventral cervicomedullary compression.
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Recommendation Grading

Disclaimer

Overview

Title

Os Odontoideum

Authoring Organization

Publication Month/Year

March 1, 2013

Last Updated Month/Year

January 12, 2023

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Document Objectives

The present review is undertaken to update the medical evidence on the diagnosis and management of patients with os odontoideum since that 2002 publication

Target Patient Population

Patients with os odontoideum

Inclusion Criteria

Female, Male, Adolescent, Adult, Child, Older adult

Health Care Settings

Ambulatory, Hospital, Operating and recovery room, Outpatient, Radiology services

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Diagnosis, Management, Treatment

Diseases/Conditions (MeSH)

D009809 - Odontoid Process, D005592 - Fracture Fixation, D005593 - Fracture Fixation, Internal

Keywords

spinal cord, fracture fixation, os odontoideum

Source Citation

Neurosurgery, Volume 72, Issue suppl_3, March 2013, Pages 159–169, https://doi.org/10.1227/NEU.0b013e318276ee69