Management of Neglected Odontoid Fracture in the Ankylosed Spine: A Case Report and Technical Note

While odontoid fractures frequently lead to non-union in elderly population, they are relatively rare in the younger age group. We present our management of a rare case of neglected odontoid fracture in an ankylosed spine of a young female. A 28-year-old female presented to our emergency department with neck deformity after a history of fall 1 year back. She presented with clinical symptoms and signs of cervical myelopathy. Diagnostic imaging confirmed ankylosis of the cervical spine with a non-union of the odontoid fracture with atlantoaxial instability and kyphosis. She was treated with anterior release of the odontoid through a standard Smith-Robinson approach, anatomical reduction, and posterior occipitocervical stabilization and fusion. Non-union with a malpsitioned odontoid fracture in an ankylosed spine can be addressed by an anterior release and reduction with posterior fusion with good functional outcome.