J Korean Soc Radiol.  2017 Mar;76(3):233-236. 10.3348/jksr.2017.76.3.233.

Traumatic Posterior Atlantoaxial Dislocation without Fracture of the Odontoid Process: A Case Report and Literature Review

Affiliations
  • 1Department of Radiology, Chonnam National University Hospital, Gwangju, Korea.
  • 2Department of Radiology, Chonnam National University Medical School, Gwangju, Korea.
  • 3Department of Radiology, Chonnam National University Hwasun Hospital, Hwasun, Korea.
  • 4Department of Radiology, Chonnam National University Bitgoeul Hospital, Gwangju, Korea. vet-lee@hanmail.net

Abstract

Traumatic posterior atlantoaxial dislocation without odontoid fracture is very rare. Patient prognosis depends on the neurologic symptoms or the extent of damage to the structures. In this case, a 78-year-old-male suffered a posterior atlantoaxial dislocation without odontoid fracture after a traffic accident. We report this case because an exact diagnosis and proper treatment can reduce the neurologic complications in patients with posterior atlantoaxial dislocation.


MeSH Terms

Accidents, Traffic
Diagnosis
Dislocations*
Humans
Multimodal Imaging
Neurologic Manifestations
Odontoid Process*
Prognosis

Figure

  • Fig. 1. Traumatic posterior atlantoaxial dislocation without fracture of the odontoid process in a 78-year-old man. Cervical spine lateral radiography (A) shows posterior dislocation of the atlas with respect to the axis. Axial computed tomography (CT) scan (B) shows that the odontoid process is located anterior to the atlas. Sagittal CT image (C) demonstrates no evidence of odontoid fracture. T2-weighted sagittal magnetic resonance (MR) (D) and fat suppression T2-weighted sagittal MR (E) demonstrate ruptured anterior longitudinal and posterior longitudinal ligaments (arrows). Also, the apical ligament (black arrowhead) is detached from the odontoid process. T2-weighted sagit-tal (D) and coronal MR (F) images show an intact transverse ligament (white arrowheads). Fluid collection or hematoma is noted in the upper cervical prevertebral and epidural regions (asterisks on image D, E and G). There is no spinal cord signal abnormality.


Reference

1. Garber JN. Abnormalities of the atlas and axis vertebrae–congenital and traumatic. J Bone Joint Surg Am. 1964; 46:1782–1791.
Article
2. Alker GJ Jr, Oh YS, Leslie EV. High cervical spine and cra-niocervical junction injuries in fatal traffic accidents: a ra-diological study. Orthop Clin North Am. 1978; 9:1003–1010.
Article
3. Xu Y, Li F, Guan H, Xiong W. Traumatic posterior atlantoaxial dislocation without associated fracture but with neu-rological deficit: a case report and literature review. Medicine (Baltimore). 2015; 94:e1768.
4. Steinmetz MP, Mroz TE, Benzel EC. Craniovertebral junction: biomechanical considerations. Neurosurgery. 2010; 66(3 Suppl):7–12.
5. Haralson RH 3rd, Boyd HB. Posterior dislocation of the atlas on the axis without fracture. Report of a case. J Bone Joint Surg Am. 1969; 51:561–566.
6. Sud S, Chaturvedi S, Buxi TB, Singh S. Posterior atlantoaxial dislocation without associated fracture. Skeletal Radiol. 2002; 31:529–531.
7. Doherty BJ, Heggeness MH. Quantitative anatomy of the second cervical vertebra. Spine (Phila Pa 1976). 1995; 20:513–517.
Article
8. Tucker SK, Taylor BA. Spinal canal capacity in simulated displacements of the atlantoaxial segment: a skeletal study. J Bone Joint Surg Br. 1998; 80:1073–1078.
9. Chaudhary R, Chaudhary K, Metkar U, Rathod A, Raut A, Sanghvi D. Posterior atlantoaxial dislocation without odontoid fracture. Skeletal Radiol. 2008; 37:361–366.
Article
10. Wong DA, Mack RP, Craigmile TK. Traumatic atlantoaxial dislocation without fracture of the odontoid. Spine (Phila Pa 1976). 1991; 16:587–589.
Article
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