Die Fusion des craniocervicalen Übergangs mit dem „Cervi Fix“ nach überlebter atlanto-occipitaler Dislokation

Köhler, H.; Vock, B.; Hochstein, P.; Wentzensen, Andreas

doi:10.1007/s001040050476

Cited by 6 publications

(14 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A new technique for stabilization of AOD was described using transarticular fixation with additional occipito-cervical Y-plate fixation [38]. Fusion with the Cervifix system with a bone graft from the iliac crest with or without cancellous bone is an alternative dorsal stabilization procedure [51,55] and was also applied in two of our four patients. The implant is made from titanium allowing postoperative CT scans with fewer artefacts.…”

Section: Discussionmentioning

confidence: 99%

Atlanto-occipital dislocation: four case reports of survival in adults and review of the literature

Labler

Eid

Platz

et al. 2004

European Spine Journal

View full text Add to dashboard Cite

IntroductionFractures and dislocations of the cranio-cervical junction represent one-third of all injuries to the cervical spine. They are usually caused by high-energy trauma such as traffic accident or fall from a great height [3, 9]. Atlantooccipital dislocation (AOD), because of its accompanying injuries to the brain stem and lesions to the vascular structures of the neck, is mostly a lethal injury [11,32,98]. The diagnosis is often overlooked [74]. Recognition of AOD and therapeutic procedures are hampered by the frequent combination of AOD with traumatic brain injury and/or polytrauma. In this article four adult patients with AOD are presented and two showed a long-term survival and were surgically treated. Case reports Case 1A 22-year-old man fell 12 m from a roof, was unconscious and had a Glasgow Coma Scale (GCS) of three points for an unknown time. Cardiac arrest and apnea occurred after arrival of the rescue team. Following successful resuscitation and intubation, the patient was transferred to the emergency ward of the University Hospital of Zurich without relaxation or sedation. The GCS was unchanged, pupillary light reactions and vital signs were normal. Except for a generalized brain edema in the computed tomography (CT) scan of the head, there were no pathological findings in the clinical and radiological work-up. After insertion of a subdural catheter for intracranial pressure (ICP) monitoring, the patient was transferred to the intensive care unit (ICU). On the first posttraumatic day, clinical neurological examination showed bilateral cranial Abstract Traumatic atlanto-occipital dislocation (AOD) is a rare cervical spine injury and in most cases fatal. Consequently, relatively few case reports of adult patients surviving this injury appeared in the literature. We retrospectively report four patients who survived AOD injury and were treated at our institution. A young man fell from height and a woman was injured in a traffic accident. Both patients survived the injury but died later in the hospital. The third patient had a motorcycle accident and survived with incomplete paraplegia. The last patient, a man involved in a working accident, survived without neurological deficit of the upper extremities. Rigid posterior fixation and complete reduction of the dislocation were applied in last two cases using Cervifix together with a cancellous bone grafting. Previously reported cases of patients surviving AOD are reviewed, and clinical features and operative stabilisation procedures are discussed.

show abstract

Section: Discussionmentioning

confidence: 99%

Atlanto-occipital dislocation: four case reports of survival in adults and review of the literature

Labler

Eid

Platz

et al. 2004

European Spine Journal

View full text Add to dashboard Cite

show abstract

“…And also, the apical dental ligament, the two accessoric ligaments, and in particular the paired alar ligaments, which compensate rotatory stress most efficiently [7,8,10], the longitudinal part of the cruciate ligament in conjunction with the broad tectorial membrane as extension of the posterior longitudinal ligament ( Figure 8) [4,5,11,12]. Especially, the latter ones are supposed to contribute most to the stability of the OCJ [4-6, 12, 13] and discussions about instability and treatment concepts are recommended on the basis of these structures [4,9,11,14]. Sun et al [15] emphasized that the disruption of the tectorial membrane is likely the threshold for instability of the atlantooccipital region.…”

Section: Functional Anatomy and Pathomechanics Of Aodmentioning

confidence: 99%

“…Accordingly, the pathologic mechanisms of AOD have been linked to the essential stabilizers of the OCJ, particularly the tectorial membrane and the alar ligaments [14,[16][17][18]. They included all force vectors affecting the cervical spine [4,5,14,17,18], whereas also experimental AOD have been observed by differing forces [19,20].…”

Section: Functional Anatomy and Pathomechanics Of Aodmentioning

confidence: 99%

“…They included all force vectors affecting the cervical spine [4,5,14,17,18], whereas also experimental AOD have been observed by differing forces [19,20]. But ligamentous disruption by these forces might also happen in adjacent segments [21].…”

Section: Functional Anatomy and Pathomechanics Of Aodmentioning

confidence: 99%

“…Due to an increasing efficiency of onscene resuscitation and modern diagnostics, the surgeon should expect being faced to diagnose and treat these seldom injuries more often [1,2,11,17]. In most of the cases patients as driver or passerby suffered AOD following a high-velocity injury as result of motor vehicle accidents [1,3,8,14,[16][17][18][25][26][27][28]. As a result of a maximum impact to the upper cervical spine one also has to expect further CSI associated with AOD.…”

Section: Epidemiologymentioning

confidence: 99%

See 2 more Smart Citations

Traumatic Atlantooccipital Dislocation

et al. 2006

View full text Add to dashboard Cite

Traumatic atlantooccipital dislocation (AOD) is a severe injury which functionally separates the head from the spine. Neurological compromise or death is the common sequela. We report on a survivor after AOD, who came back to sportive activities after operative stabilization C0-2. Actually, due to the lack of large single institution series, there are no clearly recommended guidelines concerning diagnostics and treatment of AOD. Overlooking a critical review of literature, the inferences of our case are illustrated and diagnostic as well as operative treatment concepts are discussed.

show abstract

Offene Reposition und dorsale Spondylodese C0-C2 bei atlantookzipitaler Dislokation

2009

View full text Add to dashboard Cite

We report the case of a 73-year-old male patient who was suffered trauma after a syncopal fall onto a railway track in the form of an atlanto-occipital dislocation. The diagnostic revealed a bilateral fracture of the occipital condyles coupled with a ventral atlanto-occipital dislocation (Jeanneret type 4) and also an odontoid fracture (Anderson type 2). The patient underwent dorsal spondylodesis of C0-C2 in combination with Magerl's C1-C2 screw fixation. Pre-operatively and postoperatively no neurological abnormalities were found. This rarely occurring and survived traumatological situation is described using the present case as an example.

show abstract

Die Fusion des craniocervicalen Übergangs mit dem „Cervi Fix“ nach überlebter atlanto-occipitaler Dislokation

Abstract: We report a rare case of a young moped rider who suffered atlanto-occipital dislocation. He survived with tetraplegia. We discuss the accident mechanism, the anatomical particulars, and the clinical features and compare our operative treatment with the cases described in the literature.

Cited by 6 publications

References 12 publications

Atlanto-occipital dislocation: four case reports of survival in adults and review of the literature

Atlanto-occipital dislocation: four case reports of survival in adults and review of the literature

Traumatic Atlantooccipital Dislocation

Offene Reposition und dorsale Spondylodese C0-C2 bei atlantookzipitaler Dislokation

Contact Info

Product

Resources

About