![]() We excluded the possibility to perform a trans-odontoid screw fixation, despite the favourable fracture line orientation. We want to briefly discuss the factors that led us to perform a Goel-Harms fixation. Angio-CT scan showed good perfusion of both vertebral arteries. No ossifications of alar or transverse ligaments were noticed. A cervical MRI was performed, showing no compression on the neural elements. The overall bone density of cervical bone structures was normal. She underwent a cervical CT scan ( Figure 1) showing Anderson type II odontoid fracture with severe atlanto-axial anterior dislocation and fusion signs in the right C1-C2 articulation. No comorbidities were referred, apart hypertension under treatment. The physical examination was normal, except for neck pain, rated 6/10 in Visual Analogue Scale. She did not remember which vertebra was involved and had not any documentation, since she was in a foreign hospital at the time and was discharged without receiving any prescription of treatment. She had a car accident 18 months earlier, after which a cervical fracture was diagnosed. A 60-year-old woman came to our Emergency Department complaining of worsening neck pain in the last 6 months. ![]()
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