Navigated Placement of Odontoid Screw for Type 3 Anderson and D’alonzo Fracture Under Fluoroscopy–Technical Case Report

Background: Odontoid fractures, particularly Type III Anderson and D'Alonzo fractures are uncommon but potentially unstable cervical spine fractures.Precision anatomical reduction and screw fixation are paramount to re-establish alignment, ensure fracture healing, and prevent neurological compromise.Navigated anterior odontoid screw fixation is an evolving technique, with limited literature detailing its use in Type III fractures.Methods: A 60-year-old female patient developed bilateral upper limb weakness and neck pain following a road traffic accident.Motor weakness of the right upper limb was 4/5, and of the left upper limb was 3/5, and tenderness was noted at the level of C2-C3 on clinical examination.Imaging revealed Type III odontoid fracture with posterior subluxation and spinal cord edema.The patient received open reduction and internal fixation with a single anterior odontoid screw under real-time fluoroscopic guidance with a C-arm navigation system.Results: The operation was performed without complications.Intraoperative navigation provided accurate screw trajectory and optimal reduction.Postoperative imaging confirmed appropriate screw placement and alignment.The patient showed neurological improvement in the early postoperative period. Conclusion:This case shows that anterior odontoid screw fixation using C-arm navigation is a viable and safe treatment for unstable Type III odontoid fractures.Intraoperative real-time visualization enhances the accuracy of the surgery, reducing the risk of malposition and improving results.This case shows the expanding role of intraoperative navigation in spinal trauma surgery and provides quality evidence to validate its application in cervical spine injury with complex cases.