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March 1956

Fracture of the Odontoid Process: Report of Sixty-Three Cases

Author Affiliations

Beverly Hills, Calif.; Los Angeles
From the Neurosurgical Service of the Los Angeles County Hospital; The Department of Neurosurgery, College of Medical Evangelists, and the Department of Neurosurgery, School of Medicine, University of Southern California.

AMA Arch Surg. 1956;72(3):377-393. doi:10.1001/archsurg.1956.01270210007002

Fracture of the odontoid process has in the past been considered an uncommon lesion with a discouragingly high fatality rate. Osgood and Lund28 reviewed the subject in 1928 and found the mortality rate to be more than 50% in the 55 cases reported to that date. Since then, however, there has been an increase in the number of recognized odontoid fractures because of the mounting numbers and severity of accidents as well as improvements in x-ray diagnosis. We reviewed the records of 63 previously unreported cases diagnosed since January, 1939. Although other serious injuries often made treatment difficult, death occurred in only five (8%) and only three failed to heal.

Many odontoid fractures as well as other injuries of the upper cervical spine remain overlooked. In conventional roentgenograms of the neck, teeth, mastoid processes, and base of the skull sometimes obscure details of the atlas and axis. Initial films