Delayed development of os odontoideum after traumatic cervical injury: Support for a vascular etiology

Corinna C. Zygourakis, Kevin S. Cahill, Mark R. Proctor

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


A previously healthy 2-year-old girl sustained a C1-2 ligamentous injury after a motor vehicle accident and underwent successful halo immobilization, with postimmobilization images showing good cervical alignment. At the time, plain radiography, CT scanning, and MR imaging showed a normal odontoid. Four years later, however, the patient was found to have an os odontoideum, evident on plain radiography and CT imaging. At the 10-year follow-up, the os odontoideum had not been surgically repaired, and the child had mild hypermobility. This is the first documented case in the modern imaging era of delayed os odontoideum formation after definitive CT scanning showed no fracture. As such, this suggests that os odontoideum may result from traumatic vascular interruption in the developing spine, with resulting osseous remodeling leading to an os odontoideum. This case argues against the congenital etiology of os odontoideum, as well as the strict posttraumatic theory whereby a trauma-induced odontoid fracture leads to osseous remodeling and subsequent development of an os odontoideum.

Original languageEnglish (US)
Pages (from-to)201-204
Number of pages4
JournalJournal of Neurosurgery: Pediatrics
Issue number2
StatePublished - Feb 2011
Externally publishedYes


  • C1-2 instability
  • Cervical spine
  • Etiology of os odontoideum
  • Os odontoideum

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology


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