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and had minimum follow-up of two-years. Diagnosis, levels fused, rhBMP-2 dose, complications, and fusion (Lenke grade applied by two neuroradiologists) were assessed. Results: 53 patients (22 men/31 women) met inclusion criteria, with a mean age of 55.7 years and an average follow-up of 40 months. Surgical indications included basilar invagination (n=6), fracture (n=6), atlanto-axial instability (n=16), kyphosis/kyphoscoliosis (n=22), osteomyelitis (n=1), spondylolisthesis (n=1), cyst (n=1). 15 patients had confirmed rheumatoid disease. The average rhBMP-2

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Kathryn M. Van Abel, Grant W. Mallory, Jan L. Kasperbauer, M.D., Eric J. Moore, Daniel L. Price, Erin K. O’Brien, Kerry D. Olsen, William E. Krauss, Michelle J. Clarke, Mark E. Jentoft, and Jamie J. Van Gompel

, Liang ML , Ho CY , Wong TT : Endoscopic transnasal transclival odontoidectomy: a new approach to decompression: technical case report . Neurosurgery 63 : 1 Suppl 1 ONSE92 – ONSE94 , 2008 28 Yadav YR , Madhariya SN , Parihar VS , Namdev H , Bhatele PR : Endoscopic transoral excision of odontoid process in irreducible atlantoaxial dislocation: our experience of 34 patients . J Neurol Surg A Cent Eur Neurosurg 74 : 162 – 167 , 2013 29 Yu Y , Wang X , Zhang X , Hu F , Gu Y , Xie T : Endoscopic transnasal odontoidectomy

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Michelle J. Clarke, Patricia L. Zadnik, Mari L. Groves, Daniel M. Sciubba, Timothy F. Witham, Ali Bydon, Ziya L. Gokaslan, and Jean-Paul Wolinsky

, Gokaslan ZL : Management of atlantoaxial metastases with posterior occipitocervical stabilization . J Neurosurg 98 : 2 Suppl 165 – 170 , 2003 11 Fujita T , Kawahara N , Matsumoto T , Tomita K : Chordoma in the cervical spine managed with en bloc excision . Spine (Phila Pa 1976) 24 : 1848 – 1851 , 1999 12 George B , Archilli M , Cornelius JF : Bone tumors at the cranio-cervical junction. Surgical management and results from a series of 41 cases . Acta Neurochir (Wien) 148 : 741 – 749 , 2006 13 Hsieh PC , Galia GL , Sciubba

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Christopher S. Graffeo, Avital Perry, Ross C. Puffer, Lucas P. Carlstrom, Wendy Chang, Grant W. Mallory, and Michelle J. Clarke

10.1097/00007632-200006010-00004 10828914 18 Hénaux PL , Cueff F , Diabira S , Riffaud L , Hamlat A , Brassier G , : Anterior screw fixation of type IIB odontoid fractures in octogenarians . Eur Spine J 21 : 335 – 339 , 2012 22008867 10.1007/s00586-011-2044-7 19 Kirankumar MV , Behari S , Salunke P , Banerji D , Chhabra DK , Jain VK : Surgical management of remote, isolated type II odontoid fractures with atlantoaxial dislocation causing cervical compressive myelopathy . Neurosurgery 56 : 1004 – 1012 , 2005 15854248

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Asdrubal Falavigna

nonunion. The radiological features of Type II odontoid fractures were also not examined in the study. The radiographic classification of Type II odontoid fracture can be performed according to 1) degree of displacement or dislocation of the odontoid process, 2) fracture line anatomy (anterior oblique, posterior oblique, or horizontal), 3) gap fracture, 4) degree of atlantoaxial instability/subluxation across each C1–2 facet joint, 5) presence of a comminuted fracture, and 6) surface contact area between the odontoid and the body of C-2. It would be useful if, in the

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orthosis, 2 with a Minerva brace, and 1 with a halo. Two patients required cervical surgery; an occipital cervical fusion for a type 2 odontoid fracture and one atlantoaxial fusion for atlantoaxial instability was performed. At the follow up appointments, none of the patients were found to have delayed instability based on clinical examination, upright x-rays or flexion-extension x-rays. Conclusion: All isolated OCF are likely stable injuries. Our data suggests all isolated OCF may be treated conservatively with any type of cervical orthosis and minimal follow up