Acute Traumatic Atlantoaxial Dislocation (AAD) in Adults

Suchomel, Petr; Frič, Radek

doi:10.1007/978-3-642-13158-5_15

Cited by 2 publications

(2 citation statements)

References 33 publications

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“…Traumatic atlantoaxial dislocation is an often lethal injury involving atlas-axis fractures, fracture of odontoid process, and/or other cervical spine fractures that result from high-velocity trauma. 5 Traumatic atlantoaxial dislocation may occur with concurrent fracture of the odontoid process. [11][12][15][16][17][18][19][22][23][24] However, C1-C2 subluxation has also been identified in patients with old odontoid fractures.…”

Section: Prevalencementioning

confidence: 99%

“…Traumatic atlantoaxial dislocation is an often lethal injury involving atlas-axis fractures, fracture of odontoid process, and/or other cervical spine fractures that result from high-velocity trauma. 5 Furthermore, fractures of the odontoid process are usually more common in the elderly and may go unnoticed due to a lack of neurological deficit. 6 Odontoid fractures are known to predispose toward atlantoaxial instability.…”

Section: Introductionmentioning

confidence: 99%

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Traumatic Atlantoaxial Lateral Subluxation With Chronic Type II Odontoid Fracture: A Case Report

et al. 2019

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Background: We report a case of an elderly patient who was diagnosed with lateral atlantoaxial subluxation with type II odontoid fracture, an extremely uncommon upper cervical spine injury that has not been previously reported in the literature to the knowledge of the authors. Methods: An 87-year-old male reported to the emergency room following a syncopal episode after sustaining a fall. He complained of dizziness, fatigue, disruption of vision and audition, and worsening neck pain. Computed tomographic scans were positive of partial dislocation of the C1 relative to C2 and chronic fracture of dens classified as type II according to the Anderson and D'Alonzo classification system. Magnetic resonance imaging further revealed large fracture pannus tissue at the level of the dens, reducing the space in the spinal cord. There was no evidence of spinal cord injury. Atlas-axis fusion with instrumentation was performed to manage the injury. A review of the classification, occurrence, and management of upper cervical spine surgeries was performed. Results: An acute injury to a previously unrecognized type II odontoid fracture with partial C1-C2 dislocation was identified as a rare upper cervical spine injury and classified based on the Anderson and D'Alonzo and Fielding and Hawkins classification systems. The decision was made to perform instrumented spinal fusion by inserting mass screws into C1, pars screws into C2, and locking rods to realign the vertebral bodies and address the atlantoaxial instability. Follow-up scans indicated good postsurgical reduction and fixation, including resolution of the pannus overgrowth without direct intervention. Conclusions: Lateral atlantoaxial subluxation with chronic type II fracture of the dens constitutes a rare injury of the upper cervical vertebrae. Posterior instrumented spinal fusion was used to effectively manage the injury, leading to reabsorption of retro-odontoid pannus tissue.

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Section: Prevalencementioning

confidence: 99%

“…Traumatic atlantoaxial dislocation is an often lethal injury involving atlas-axis fractures, fracture of odontoid process, and/or other cervical spine fractures that result from high-velocity trauma. 5 Furthermore, fractures of the odontoid process are usually more common in the elderly and may go unnoticed due to a lack of neurological deficit. 6 Odontoid fractures are known to predispose toward atlantoaxial instability.…”

Section: Introductionmentioning

confidence: 99%

Traumatic Atlantoaxial Lateral Subluxation With Chronic Type II Odontoid Fracture: A Case Report

et al. 2019

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Traumatic atlantoaxial rotatory subluxation in an adolescent: a case report

et al. 2012

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IntroductionAtlantoaxial 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 presentationWe 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.ConclusionIn 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.

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Acute Traumatic Atlantoaxial Dislocation (AAD) in Adults

Cited by 2 publications

References 33 publications

Traumatic Atlantoaxial Lateral Subluxation With Chronic Type II Odontoid Fracture: A Case Report

Traumatic Atlantoaxial Lateral Subluxation With Chronic Type II Odontoid Fracture: A Case Report

Traumatic atlantoaxial rotatory subluxation in an adolescent: a case report

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