Hamilton Preci, Lawrence Peyton, Eisenring Christian Valentin
Division of Neurosurgery, Department of Surgery, Radiology, Anaesthesia and Intensive Care, University Hospital of the West Indies, University of the West Indies, Kingston, Jamaica.
Department of Neurosurgery, Hirslanden Hospital, Zurich, Switzerland.
J Surg Case Rep. 2020 Aug 26;2020(8):rjaa235. doi: 10.1093/jscr/rjaa235. eCollection 2020 Aug.
Odontoid fractures constitute the commonest cervical spinal fracture in the elderly. There are varied management approaches with paucity of robust evidence to guide decision-making. We review the case of a 92-years-old man with traumatic Grauer type II B odontoid fracture treated with anterior cannulated screw fixation. Postoperatively, he was noted to have dysphagia due to a zenker's diverticulum. Further history revealed repair of a zenker's diverticulum ~40 years prior. Cervical spine images and video fluoroscopy demonstrated a recurrent zenker's diverticulum. After re-excision of the recurrent zenker's diverticulum his dysphagia resolved. This unique case describes dysphagia due to recurrent zenker's diverticulum presenting after anterior cannulated screw fixation for type II B odontoid fracture. The dysphagia was diagnosed and treated in close collaboration with speech and language therapists and otorhinolaryngologist. This underscores the importance of holistic approach to the elderly patient with odontoid fractures.
齿突骨折是老年人中最常见的颈椎骨折。治疗方法多样，但缺乏有力证据来指导决策。我们回顾了一例92岁男性患者的病例，该患者因创伤性Grauer II B型齿突骨折接受前路空心螺钉内固定治疗。术后，他因Zenker憩室出现吞咽困难。进一步询问病史发现，约40年前曾行Zenker憩室修复术。颈椎影像和视频透视显示为复发性Zenker憩室。再次切除复发性Zenker憩室后，他的吞咽困难得以缓解。这个独特的病例描述了II B型齿突骨折前路空心螺钉内固定术后因复发性Zenker憩室导致的吞咽困难。吞咽困难是在与言语和语言治疗师以及耳鼻喉科医生密切合作下诊断和治疗的。这凸显了对老年齿突骨折患者采取整体治疗方法的重要性。
