[Post-traumatic unilateral atlanto-axial rotatory subluxation in an adult].
This retrospective single-patient case report deals with a rare form of spinal trauma, i.e. atlantoaxial rotatory subluxation. The authors present a review of the literature including a classification of rotatory atlantoaxial subluxation types proposed by Fielding, and describe their own experience with treatment of this condition. A case is reported of a 29-year-old woman with a history of head contusion in a car accident. Immediately after the trauma she had the following symptoms: torticollis and neck pain with decreased cervical motion. Atlantoaxial rotatory subluxation of the right C1-C2 articulation was diagnosed by plain radiographs and CT. The patient was treated surgically by an open reduction, unilateral screw fixation of the right CI-C2 articulation (according to Magerl) and posterior C1-C2 wiring with graft. The normal atlantoaxial relation was restored with disappearance of torticollis. At follow-up certain limitation of neck movements due to C1-C2 stabilization persisted. No complications were noted. The patient remains neurologically intact and has radiographic documentation of fusion.
Radek
Andrzej
A
Kliniki Neurochirurgii i Chirurgii Nerwów Obwodowych Uniwersyteckiego Szpitala Klinicznego Nr 2 im. WAM w Łodzi.
Zapałowicz
Krzysztof
K
Grochal
Marek
M
Błaszczyk
Bogdan
B
Myśliński
Ryszard
R
Kaczorowska
Beata
B
D000328:Adult; D001268:Atlanto-Axial Joint / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D001864:Bone Wires; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D009333:Neck; D012399:Rotation; D012720:Severity of Illness Index; D013124:Spinal Injuries / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014103:Torticollis / Q000175:diagnosis / Q000503:physiopathology