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CC BY 4.0 · J Neurol Surg Rep 2025; 86(04): e225-e229
DOI: 10.1055/a-2731-4673
Case Report

Low-cost Posterior C1–C2 Fusion Using Sublaminar Wiring in Neurologically Intact Young Patient with Type IIA Odontoid Fracture: A Resource-oriented Approach

Autoren

  • Carlos Novondo 

    1   Neurocirugía, Hospital Dr. Mario Catarino Rivas, San Pedro Sula, Cortés, Honduras
    2   Neurocirugía, Hospital Militar del Norte, San Pedro Sula, Cortés, Honduras

  • César Alas-Pineda 

    3   Quantitative Biomedical Sciences, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, United States

  • Anahi Gisselle Pacheco 

    4   Facultad de Medicina y Cirugía, Universidad Católica de Honduras - Campus San Pedro y San Pablo, San Pedro Sula, Cortés, Honduras

  • Clarisa L. Reyes-Guardado 

    4   Facultad de Medicina y Cirugía, Universidad Católica de Honduras - Campus San Pedro y San Pablo, San Pedro Sula, Cortés, Honduras

  • Kristhel Gaitán-Zambrano 

    4   Facultad de Medicina y Cirugía, Universidad Católica de Honduras - Campus San Pedro y San Pablo, San Pedro Sula, Cortés, Honduras
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Abstract

Purpose

To present a low-cost posterior cervical fixation technique using sublaminar wiring for the management of a comminuted odontoid fracture (type IIA) in a young, neurologically intact patient, emphasizing its relevance in low-resource environments where advanced instrumentation is inaccessible.

Methods

A 21-year-old male sustained a comminuted fracture of the odontoid process of C2 following a high-impact motorcycle accident. Upon admission, he was alert, fully oriented, and neurologically intact. Imaging revealed a comminuted type IIA odontoid fracture without displacement. Due to the patient's economic limitations and the unsuitability of the fracture for anterior fixation, a posterior approach using double sublaminar wiring between C1 and C2 with autologous iliac crest bone graft was performed.

Results

The procedure was successfully completed with no intraoperative or postoperative complications. The patient was discharged on postoperative day 2 and demonstrated excellent recovery. Follow-up imaging at 3 months confirmed over 90% fracture consolidation. Imaging at 6 months was requested but not obtained due to loss of follow-up. Functional recovery was complete, with only a partial reduction in cervical range of motion as expected with C1–C2 fusion.

Conclusion

Sublaminar wiring offers a safe, effective, and affordable alternative for posterior fixation of comminuted odontoid fractures, particularly in young patients and in settings where access to advanced spinal instrumentation is limited.

Keywords

odontoid fracture - C2 fracture - sublaminar wiring - cervical spine trauma - case report - low-cost spinal surgery

Contributors' Statement

C.U.A.-P., C.N., A.G.P.: conceptualization; C.U.A.-P., A.G.P.: formal analysis; C.U.A.-P., C.N., A.G.P., C.L.R.-G., K.G.-Z.: investigation; C.U.A.-P., C.N., C.L.R.-G., K.G.-Z.: methodology; C.U.A.-P., C.N., A.G.P., C.L.R.-G., K.G.-Z.: project administration; C.U.A.-P., A.G.P., C.L.R.-G., K.G.-Z.: writing—original draft. C.U.A.-P., C.N., A.G.P., C.L.R.-G., K.G.-Z.: writing—review and editing.


Informed Consent

Written informed consent was obtained from the patient for publication of this case report and any accompanying images.


Note

This case report was prepared following the CARE Guidelines.[23]




Publikationsverlauf

Eingereicht: 24. Juni 2025

Angenommen: 21. September 2025

Accepted Manuscript online:
27. Oktober 2025

Artikel online veröffentlicht:
12. November 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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