Korean J Neurotrauma.  2013 Apr;9(1):27-29. 10.13004/kjnt.2013.9.1.27.

Combined Atlantoaxial Rotatory Fixation and Unilateral Counter Occipitoatlantal Subluxation after Minor Trauma

• Lee SH
• Cha JH
• Song JS
• Heo W

• KMID: 1427760
• DOI: http://doi.org/10.13004/kjnt.2013.9.1.27

Abstract

Rotatory fixation of the atlantoaxial joint is relatively rare in adults but somewhat more common in children. Most of them are reduced spontaneously or after traction. However, combined rotatory injury of atlantoaxial joint and unilateral occipitoatlantal subluxation is a rare disease, and it is often difficult to diagnose accurately. Because the craniovertebral junction is complex and patients with combined atlantoaxial rotatory fixation (AARF) and occipitoatlantal subluxation has a less rotated head than patients with pure AARF. And injury of the occipitoatlantal and atlantoaxial joint can often result upper cervical instability, so early diagnosis is very important. We present a case of the combined AARF and unilateral counter occipitoatlantal subluxation after minor trauma.

Keyword

Atlantoaxial rotatory fixation; Occipitoatlantal dislocation; Arthrodesis

MeSH Terms

Adult
Arthrodesis
Atlanto-Axial Joint
Child
Early Diagnosis
Head
Humans
Organothiophosphorus Compounds
Rare Diseases
Traction
Organothiophosphorus Compounds

Figure

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  FIGURE 1. A: Three-dimensional CT scans showing the atlantoaxial rotatory subluxation with 26 degrees. B: C1 turned to the left and subluxation with 14 degrees on the occipital condyle. OC: occipital condyle.

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  FIGURE 2. A: Left parasagittal CT reconstruction showing good articular congruence between the condyle and the lateral mass of C1. B: Right parasagittal CT reconstruction showing posterior dislocation of the condyle on the lateral mass of C1 (arrow).

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  FIGURE 3. Posterative three-dimensional CT scan (posterior view). Satisfactory reduction has been accomplished and arthrodesis at C1-C2 has been performed in which allogenic bone chips.

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  FIGURE 4. Postoperative plain X-ray film (lateral view) showing fusion between C1 and C2.

Reference

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