case_images: PMC11029102_01
case_images: Preoperative X-ray (a) and magnetic resonance imaging (b) demonstrating odontoid synchondrosis fracture with flexion displacement and prevertebral fluid collection
case_images: JCVJS-15-127-g001.jpg
case_images: PMC11029102_01_JCVJS-15-127-g001.jpg
case_images: jcvjs_184_23-f001
case_images: X-ray and computerized tomography (CT) imaging of the patient's cervical spine revealed an odontoid synchondrosis fracture with flexion displacement [Figure 1]. This demonstrated cerebrospinal fluid effacement and indentation of the spinal cord without signal change at the C1-C2 level [Figure 1].
case_images: Diagrammatic representation of C1-C2 sublaminar taping operative technique. (a) Posterior spinal fixation band passer bent and passed under the right C1 posterior arch. (b) The fixation band was passed around the C2 spinous process and under the left C1 posterior arch. (c) The band was passed back under the C2 spinous process and the C1-C2 distraction reduced. The band was tensioned, clamped, held with sutures, and reinforced with ligation clips (d)
case_images: JCVJS-15-127-g002.jpg
case_images: PMC11029102_01_JCVJS-15-127-g002.jpg
case_images: jcvjs_184_23-f002
case_images: A posterior spinal fixation band malleable leader (3.0 mm NILE Alternative Fixation Spinal System) was bent and under direct vision passed under the right C1 posterior arch in a caudal to cephalad direction [Figure 2a]. The tape was then passed around the C2 spinous process, deep to the supraspinous ligament [Figure 2b]. The tape was passed under the left C1 posterior arch in an identical manner to that performed on the right [Figure 2b] and brought back around under the C2 spinous process. Sutures were passed through the band to secure the reduction [Figure 2c] and reinforced with ligating clips [Figure 2d].
case_images: (a) Anatomical reduction of synchondrosis fracture immediately postoperatively and in halo jacket and (b) 3 months postoperatively with complete union
case_images: JCVJS-15-127-g003.jpg
case_images: PMC11029102_01_JCVJS-15-127-g003.jpg
case_images: jcvjs_184_23-f003
case_images: Formal postoperative X-rays were obtained [Figure 3a]. X-rays at 6 months revealed stable anatomical alignment with union [Figure 3b].