Neglected Posttraumatic Atlantoaxial Spondyloptosis with Type 2 Odontoid Fracture: A Case Report

INTRODUCTION: In atlantoaxial context, spondyloptosis has been defined as a situation when both the inferior facets of atlas are fixed anterior to the superior facets of axis. Such an injury scenario is a rare presentation with a few reported cases in available literature. CASE REPORT: We present a case of post-traumatic anterior atlantoaxial dislocation or spondyloptosis associated with a Type 2 odontoid fracture in an adult patient who presented to us 3 months after injury. After failed attempts of closed reduction with traction, open reduction and posterior instrumentation with fusion were done using joint remodeling technique. 6-month follow-up showed completely reduced facet joints with near complete fusion. CONCLUSION: Long-standing complete C1-C2 dislocations pose a challenge for a surgeon because of the associated difficulty in joint reduction. Joint remodeling and manipulation have antiquated transoral odontoidectomy as excellent results have been achieved by direct posterior approach.