Os Odontoideum
Publication Date: March 1, 2013
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
Congress of Neurological Surgeons
Publication Month/Year
March 1, 2013
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