Extract
Treatment of fractures of the odontoid process of the axis (the dens) has
the potential to stabilize a critical injury or result in a high degree of
morbidity or even death. We present the case of a patient in whom myelopathy
developed more than thirty-nine years after he sustained a dens fracture while
playing football. This case is unique because of the prolonged asymptomatic
interval between the injury and the development of the myelopathy, during
which time the patient worked as a manual laborer. The late onset of
progressive myelopathy after a dens fracture is considered
uncommon1,2
and, to our knowledge, this case represents the second longest delay between a
dens fracture and the onset of myelopathy in the English-language literature.
The myelopathy resolved after surgical stabilization, and the four-year
clinical and radiographic follow-up data are presented. Our patient was
notified that data concerning this case would be submitted for
publication.