Traumatic atlantoaxial distraction injury : A case report

Case report. Description of a rarely reported variant of traumatic C1-C2 dislocation and discussion of a favorable outcome in a nonsurgical treatment approach. Atlantoaxial dislocation most commonly involves an anterior movement of C1 in relation to C2. Often, the integrity of the transverse ligamen...

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Bibliographic Details
Published in:Spine (Philadelphia, Pa. 1976) Pa. 1976), 2001-02, Vol.26 (4), p.454-457
Main Authors: CARROLL, Eben A, GORDON, Brian, SWEENEY, Colleen A, JOY, Stephen, CONNOLLY, Patrick J
Format: Article
Language:English
Subjects:
Accidents, Traffic
Adult
Axis, Cervical Vertebra - diagnostic imaging
Axis, Cervical Vertebra - injuries
Axis, Cervical Vertebra - pathology
Biological and medical sciences
Cervical Atlas - diagnostic imaging
Cervical Atlas - injuries
Cervical Atlas - pathology
Diseases of the osteoarticular system. Orthopedic treatment
Female
Humans
Joint Dislocations - diagnostic imaging
Joint Dislocations - pathology
Joint Dislocations - therapy
Medical sciences
Radiography
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Recovery of Function - physiology
Spinal Injuries - diagnostic imaging
Spinal Injuries - pathology
Spinal Injuries - therapy
Traction
Treatment Outcome
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Summary:Case report. Description of a rarely reported variant of traumatic C1-C2 dislocation and discussion of a favorable outcome in a nonsurgical treatment approach. Atlantoaxial dislocation most commonly involves an anterior movement of C1 in relation to C2. Often, the integrity of the transverse ligament or odontoid process is compromised, and the atlantodental interval changed. The described patient sustained a purely craniocaudal atlantoaxial distractive lesion secondary to injury sustained in a high-speed motor vehicle accident. The initial treatment plan involved surgical stabilization subsequent to healing of a C1 ring fracture. After 12 weeks of external stabilization, ligamentous damage appeared well resolved. That there was no gross instability delayed using a surgical option. At periodic checkup, the patient was without symptoms. In this case, conservative management of a ligamentous C1-C2 injury was effective. At 5 years after trauma the patient was without sequelae. This outcome is in contrast to previous management of injuries of this type, all of which involved surgical intervention.
ISSN:0362-2436
1528-1159
DOI:10.1097/00007632-200102150-00026