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. 2010 May;1(1):67–74. doi: 10.1055/s-0028-1100896

Table 2. Symptomatic patients treated either nonoperatively or operatively for os odontoideum and their results.

Author N Mean age (range) in years % male Preexisting diagnosis Symptoms Instability Operative treatment Mean follow-up (range) in years Results
Dai 39 25(7–56) 75%* n = 18

  • Klippel-Feil (n = 4)

  • occipitalization (n = 6)

  • Hypertrophy anterior atlantal arch (n = 5)

  • Basilar invagination (n = 2)

  • Basilar impression (n = 1)

 Local symptoms:

  • cervical pain and/or stiffness (n = 33)

  • weakness of neck (n = 21)

  • dizziness (n = 7)

  • torticollis (n = 9)

Neurological findings (n = 30):

  • transient (n = 7)

  • immediate, nontransient (n = 4)

  • late-onset progressive (n = 19)

  • myelopathy (n = 6)

  • radiculopathy(n = 2)

  • myelopathy & radiculopathy (n = 22)

  • cranial nerve defects (n = 8)

 95% yes 6.5 (1–16) Fusion: 100%
All symptoms

  • resolved: 67%

  • improved: 33%
Fielding 35 19 (3–65) 60%

  • Down's syndrome (n = 1)

  • Klippel-Feil (n = 1)

  • Dysplasia (n = 4)

  • Pain (n = 16)

  • Neurological (n = 17)

  • Other (n = 14)

 100% yes 3.4 (1–10) All symptoms

  • resolved: 88%

  • worse: 0%
Gluf 22 10(4–16) 66%† ns Not described 100% yes 2.8 (0.25–8.9) Fusion: 100%
Klimo 78 21 (1.5–73) 62% n = 5

  • Down's syndrome (n = 3)

  • Spondyloepiphyseal dysplasia (n = 1)

  • Metatrophic dwarfism (n = 1)

  • Pain (n = 50)

  • Myelopathy (n = 18)

  • Intermittent neuropathy (n = 15)

 77% ant: 70% post: 10% A-P: 13% yes 1.2 (0.1–9.6) Fusion: 100%
Pain

  • resolved: 68%

  • improved: 20%

  • unchanged: 12%

Neuropathy

  • resolved: 39%

  • improved: 50%

  • unchanged: 11%
Menezes 134 4–58 55%

  • Morquio's (n = 2)

  • Down's syndrome (n = 10)‡

  • Acute neurological deterioration following trauma (n = 63)

  • Symptoms insidious (n = 71)

 yes yes ns Fusion: 98.5%

  • 2nd fusion required to extend initial C1-C2 fusion (n = 16)
Spierings 36 38 (6–62) 78%

  • Down's syndrome (n = 1)

 Group A: no cord symptoms (n = 15)
Group B: no cord symptoms (n = 9)
Group C: cord symptoms (n = 4)
Group D: cord symptoms (n = 8)		 nr
nr
nr
nr		 no
yes
no
yes		 8 (0.5–18) All symptoms resolved:

  • Gp A: 50%

  • Gp B: 11%

  • Gp C: 25%

  • Gp D: 25%

improved:

  • Gp A:14%

  • Gp B: 45%

  • Gp C: 50%

  • Gp D: 37%

unchanged:

  • Gp A: 29%

  • Gp B: 22%

  • Gp C: 0%

  • Gp D: 13%

worse:

  • Gp A: 7%

  • Gp B: 22%

  • Gp C: 25%

  • Gp D: 25%

nr = not reported.

*

Dai: % male includes asymptomatic and symptomatic patients.

†

Gluf reports % male for a study population of 45 patients with other diagnoses and 22 os odontoideum patients.

‡

Menezes: possibly other patients have preexisting diagnoses; these 12 patients are specifically listed as among those with reducible lesions but worsening extension.