Case ReportsSimultaneous Anterior Arthrodesis C2-3 and Anterior Odontoid Screw Fixation for Stabilization of a 4-Part Fracture of the Axis—A Technical DescriptionKoller, Heiko MD; Assuncao, Allan MD; Kammermeier, Volker MD; Holz, Ulrich Author Information Department for Trauma, Reconstructive and Hand Surgery, Katharinenhospital Stuttgart, Germany The authors did not receive any financial support in conjunction with generation of the submission. Reprints: Dr Heiko Koller, MD, Department for Trauma, Reconstructive and Hand Surgery, Katharinenhospital Stuttgart, Germany (e-mail: [email protected]). Received for publication August 20, 2005; accepted December 15, 2005 Journal of Spinal Disorders & Techniques: July 2006 - Volume 19 - Issue 5 - p 362-367 doi: 10.1097/01.bsd.0000204502.99471.9a Buy Metrics Abstract Multiple fractures of the axis are rare and present challenging patterns of instability in cervical spine surgery. Once a surgeon is faced with a combination of fractures in the axis vertebra, including stable and unstable components, a sound treatment concept must be worked out to achieve primary stability, early mobilization, and superior outcome. We demonstrate an operative technique for the stabilization of a 4-part fracture of the axis. Utilizing anterior odontoid screw fixation and C2-3 arthrodesis, an unstable traumatic spondylolisthesis with fracture of the odontoid type IIA, and lateral mass of C2 was successfully stabilized at once. The technique enabled early postoperative mobilization of our patient, who, after 1 year, showed a favorable outcome with a pain-free range of motion. The basic thoughts guiding to treatment options in multiple fractures of the axis are discussed and our therapy concept is presented. © 2006 Lippincott Williams & Wilkins, Inc.