Tratamiento de pseudoartrosis de odontoides mediante técnica de cerclaje sublaminar modificado,asociado a síndrome del segmento adyacente C2-C3 tratado con técnica de Roy-Camille en paciente con Síndrome de Klippel-Feil

Abstract

Atlantoaxial instability (CI-C2) can be caused by trauma to the upper cervical spine, rheumatoid arthritis, tumors, infections, or congenital abnormalities. Axis fractures are the most common of the cervical spine, their incidence is 26% to 33% of all cervical injuries, more frequently in males. Clinically, the most common symptom is pain and it may or may not be associated with neurovascular lesions. The diagnosis will be made through specific radiographic projections and simple tomography of the cervical spine. The most frequent complications are underdiagnosed lesions between 40-60% and nonunion that occurs in 36%. In those cases, surgical treatment is indicated. Multiple surgical techniques have been described, including wire fixation with bone grading, pedicle, facets or transarticular screws, and combinations between those techniques. Although, the transpedicular and transarticular fixation techniques shown to be mechanically superior compared to the sublaminar techniques. Even though, both have good results. In this case, we describe a nonunion of odontoids and adjacent segment disease C2-C3 case treated with a modified sublaminar wiring CI-C2, not previously performed, and plate fusion in C2-C3 vertebra with Roy-Camille technique in a patient with Klippel-Feil syndrome.