Introduction: Odontoid fractures represent a clinically significant subset of cervical spine injuries, with an increasing incidence among the elderly population. Understanding their demographic characteristics, fracture subtypes, and treatment outcomes is crucial for optimizing management strategies and guiding prevention efforts. Methods: This retrospective study included 65 patients with odontoid fractures treated between 2018 and 2023 at a tertiary neurosurgical center. Fractures were classified according to the Anderson and D’Alonzo system and further subclassified using the Grauer classification for Type II fractures. Clinical data, including age, mechanism of injury, fracture subtype, treatment modality, and radiologic outcomes, were analyzed. Results: The mean age of the cohort was 61.9 years, with 56.9% of patients aged ≥65 years. Low-energy ground-level falls were the most common mechanism of injury (50.7%), occurring predominantly in elderly patients. According to the Anderson and D’Alonzo classification, Type II fractures were the most frequent (53.8%), followed by Type III (44.6%). Among Type II fractures, 82.5% were Type IIB. Surgical treatment was performed in 33.8% of cases—most commonly anterior odontoid screw fixation—while 66.2% were managed conservatively. CT-based follow-up (n=42) demonstrated an overall osseous union rate of 76.1%. Fusion was achieved in 84.2% of surgically treated and 69.5% of conservatively treated patients. Patients younger than 65 years had a higher fusion rate (81.8%) compared with older patients (70%). Conclusion: Odontoid fractures are predominantly geriatric injuries, most often resulting from low-energy ground-level falls. Type II fractures, particularly the IIB subtype, remain the most common and carry a higher risk of nonunion. Surgical fixation provides superior fusion rates compared to conservative treatment. These results emphasize the importance of patient-specific management and suggest that future studies should further refine treatment algorithms in light of evolving surgical techniques and demographic trends.

Spine instrumentation can be performed with intraoperative computed tomography (CT) guidance, fluoroscopy guidance, or freehand techniques. Surgical fixation of the atlantoaxial (C1–C2) junction without CT guidance remains technically challenging due to complex anatomy and proximity to critical neurovascular structures. To evaluate the feasibility of low-cost, patient-specific three-dimensional (3D)-printed anatomical models for preoperative planning of C1–C2 instrumentation. High-resolution CT and CT angiography data from 20 individuals were used to generate patient-specific 3D models of the C1–C2 vertebrae and vertebral arteries using open-source segmentation software (3D Slicer®). Models were produced as life-size replicas, with multiple fixation techniques simulated and screw angulations measured in axial and sagittal planes. Twenty patient-specific C1–C2 anatomical models were successfully produced and instrumented. Screw angulations and lengths across all fixation techniques—including C1 lateral mass, C2 pedicle, pars, translaminar, and transarticular screws—remained within established safe anatomical ranges. Each model required approximately 215 min of active printing time and a total hands-on preparation time of approximately 275–320 min, with an additional 24-h curing period for silicone processing. The material cost per model was approximately USD 0.56 using a desktop fused deposition modeling printer. Low-cost, patient-specific 3D-printed models provide anatomically consistent, life-size representations of the complex atlantoaxial region. These models may represent a practical adjunct for surgical planning, feasibility assessment, and preoperative rehearsal for various C1–C2 fixation strategies without advanced intraoperative technology. Further studies are needed to evaluate their clinical impact.

Background/Objectives: Translabyrinthine (TL) surgery is established for vestibular schwannomas, but its role in a homogeneous posterior petrous face meningioma (PPFM) cohort remains undefined. We characterized surgical, functional, and oncological outcomes and associations with extension and tumor burden. Methods: We retrospectively reviewed 14 patients undergoing TL-only resection at a single institution (2006–2024). Petrosal zones (anterior, middle, posterior) were modeled independently. Outcomes included extent of resection, Simpson grade, complications, tumor control, House–Brackmann (HB) facial nerve (FN) grade, modified Rankin Scale (mRS), and Glasgow Outcome Scale (GOS). Results: Preoperatively, 10 (71.4%) had non-serviceable or absent hearing, and the median diameter was 33.5 mm. Gross or near-total resection was achieved in 85.7% (median extent, 96.2%). At 1 year, 13 of 14 (92.9%) had HB I–II, including all 12 with favorable preoperative function; all had favorable outcomes (mRS 0–2; GOS 4–5). Over a median 65.5-month follow-up, one recurrence and three regrowths occurred, with five patients (35.7%) receiving adjuvant radiation. In exploratory analyses, anterior involvement was associated with a lower likelihood of Simpson grade 1–2 resection (p = 0.025), but not with volumetric extent; tumor diameter correlated with complication burden (ρ = 0.585; p = 0.028), and tumor volume correlated with operative duration (ρ = 0.607; p = 0.021) and hospital stay (ρ = 0.753; p = 0.002). Conclusions: In this first TL-only PPFM series, FN and functional outcomes were favorable and tumor control was acceptable under multimodal management. These findings describe outcomes achievable through the TL corridor in appropriately selected patients rather than an advantage over alternative approaches. Exploratory associations between anterior extension, tumor burden, and outcome require confirmation in larger cohorts.