Traumatic Atlantoaxial Rotatory Subluxation in an Adolescent: a Case Report

Overview

Journal J Med Case Rep

Publisher Biomed Central

Specialty General Medicine

Date 2012 Jan 25

PMID 22269577

Citations 10

Authors

Luis Enrique Meza Escobar

Georg Osterhoff

Christian Ossendorf

Guido A Wanner

Hans-Peter Simmen

Clement Ml Werner

Affiliations

Soon will be listed here.

Abstract

Introduction: Atlantoaxial rotatory subluxation is rarely caused by trauma in adults. Usually, the treatment of choice is traction using Halo/Gardner-Wells fixation devices for up to six weeks.

Case Presentation: We present the case of a 19-year-old Caucasian woman with traumatic atlantoaxial subluxation. Early reduction three hours after trauma and immobilization using only a soft collar were performed and yielded very good clinical results.

Conclusion: In the adult population, atlantoaxial subluxation is a rare condition but is severe if untreated. Early treatment implies a non-surgical approach and a good outcome. Conservative treatment is the recommended first step for this condition.

Citing Articles

Management of Adult Atlantoaxial Rotatory Fixation: Case Series with Literature Review.

Katsuyama Y, Okuda Y, Kanamura H, Sasaki K, Saito T, Nakamura S Iowa Orthop J. 2024; 43(2):96-105.

PMID: 38213850 PMC: 10777696.

Does alar ligament injury predict conservative treatment failure of atlantoaxial rotatory subluxation in adults: Case report and review of the literature.

Ng C, Dominguez J, Feldstein E, Houten J, Spirollari E, Gandhi C Spinal Cord Ser Cases. 2021; 7(1):103.

PMID: 34862363 PMC: 8642488. DOI: 10.1038/s41394-021-00464-9.

Recurrent traumatic atlantoaxial rotatory subluxation: Case report.

Tobing S, Abubakar I, Karda I Ann Med Surg (Lond). 2020; 54:65-70.

PMID: 32382411 PMC: 7198983. DOI: 10.1016/j.amsu.2020.04.005.

Traumatic Chronic Irreducible Atlantoaxial Rotatory Fixation in Adults: Review of the Literature, With Two New Examples.

Rahimizadeh A, Williamson W, Rahimizadeh S Int J Spine Surg. 2019; 13(4):350-360.

PMID: 31531285 PMC: 6724759. DOI: 10.14444/6048.

A missed traumatic atlanto-axial rotatory subluxation in an adult patient: case report.

Barimani B, Fairag R, Abduljabbar F, Aoude A, Santaguida C, Ouellet J Open Access Emerg Med. 2019; 11:39-42.

PMID: 30697088 PMC: 6339448. DOI: 10.2147/OAEM.S149296.

References

Mathern G, Batzdorf U . Grisel's syndrome. Cervical spine clinical, pathologic, and neurologic manifestations. Clin Orthop Relat Res. 1989; (244):131-46. View

Willauschus W, Kladny B, Beyer W, Gluckert K, Arnold H, Scheithauer R . Lesions of the alar ligaments. In vivo and in vitro studies with magnetic resonance imaging. Spine (Phila Pa 1976). 1995; 20(23):2493-8. DOI: 10.1097/00007632-199512000-00006. View

FIELDING J, Hawkins R . Atlanto-axial rotatory fixation. (Fixed rotatory subluxation of the atlanto-axial joint). J Bone Joint Surg Am. 1977; 59(1):37-44. View

Maile S, Slongo T . Atlantoaxial rotatory subluxation: realignment and discharge within 48 h. Eur J Emerg Med. 2007; 14(3):167-9. DOI: 10.1097/MEJ.0b013e328014081c. View

Phillips W, Hensinger R . The management of rotatory atlanto-axial subluxation in children. J Bone Joint Surg Am. 1989; 71(5):664-8. View

Crook T, Eynon C . Traumatic atlantoaxial rotatory subluxation. Emerg Med J. 2005; 22(9):671-2. PMC: 1726926. DOI: 10.1136/emj.2003.013045. View

Subach B, McLaughlin M, Albright A, Pollack I . Current management of pediatric atlantoaxial rotatory subluxation. Spine (Phila Pa 1976). 1998; 23(20):2174-9. DOI: 10.1097/00007632-199810150-00006. View

Singh V, Singh P, Balakrishnan S, Leitao J . Traumatic bilateral atlantoaxial rotatory subluxation mimicking as torticollis in an adult female. J Clin Neurosci. 2009; 16(5):721-2. DOI: 10.1016/j.jocn.2008.07.082. View

Weisskopf M, Naeve D, Ruf M, Harms J, Jeszenszky D . Therapeutic options and results following fixed atlantoaxial rotatory dislocations. Eur Spine J. 2004; 14(1):61-8. PMC: 3476677. DOI: 10.1007/s00586-004-0772-7. View

10.

Dvorak J, Penning L, Hayek J, Panjabi M, Grob D, Zehnder R . Functional diagnostics of the cervical spine using computer tomography. Neuroradiology. 1988; 30(2):132-7. DOI: 10.1007/BF00395614. View

11.

Monckeberg J, Villas Tome C, Matias A, Alonso A, Vasquez J, Zubieta J . CT scan study of atlantoaxial rotatory mobility in asymptomatic adult subjects: a basis for better understanding C1-C2 rotatory fixation and subluxation. Spine (Phila Pa 1976). 2009; 34(12):1292-5. DOI: 10.1097/BRS.0b013e3181a4e4e9. View

12.

Carter V, Fasen J, Roman Jr J, Hayes K, Petersen C . The effect of a soft collar, used as normally recommended or reversed, on three planes of cervical range of motion. J Orthop Sports Phys Ther. 1996; 23(3):209-15. DOI: 10.2519/jospt.1996.23.3.209. View

13.

Johnson R, Owen J, Hart D, Callahan R . Cervical orthoses: a guide to their selection and use. Clin Orthop Relat Res. 1981; (154):34-45. View

14.

Barros E, Rodrigues C, Rodrigues N, Oliveira R, Barros T, Rodrigues Jr A . Aging of the elastic and collagen fibers in the human cervical interspinous ligaments. Spine J. 2003; 2(1):57-62. DOI: 10.1016/s1529-9430(01)00167-x. View