Non-operative treatment in children and adolescents with atlantoaxial rotatory subluxation

Çiftdemir, Mert; Çopuroğlu, Cem; Özcan, Mert; Ulusam, Ayşe Övül; Yalnız, Erol

doi:10.5152/balkanmedj.2012.029

Cited by 10 publications

(11 citation statements)

References 11 publications

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“…9 On an open-mouth view, the asymmetry of the interspaces between the C1 lateral masses and the dens is sufficient to make a diagnosis. 5 Alternative techniques for imaging in cases of torticollis, such as CT and magnetic resonance imaging, are sensitive in ruling out traumatic or destructive processes 10 and are recommended when neurological signs and symptoms are present. 9 In general, the appropriate approach to a child presenting with acute torticollis is to first identify potential red flags, which may require emergency intervention.…”

Section: Discussionmentioning

confidence: 99%

“…If left untreated, some cases may resolve spontaneously, but other cases may cause secondary morbidities ranging from neck restriction, permanent torticollis, facial asymmetry, and even sudden death. 3,5 Cervical collar and halter traction are routinely used for patients diagnosed with AARS. 10 It is necessary to exclude all contraindications related to upper cervical instability prior to proceeding with manual therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Persistent torticollis, neurological compromise and even life-threatening results may be seen as a result of AARS. 5 The most important factor for success of conservative treatment is early diagnosis and the timing of treatment. 3…”

Section: Introductionmentioning

confidence: 99%

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Atlantoaxial Rotatory Subluxation in a 10-Year-Old Boy

Chu

Chakkaravarthy

et al. 2020

Clin Med�Insights�Arthritis�Musculoskelet Disord

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Atlantoaxial rotatory subluxation (AARS) is the loss of normal alignment and stability of the first (atlas) and second (axis) cervical vertebrae with respect to each other. We describe the clinical challenges of managing a 10-year-old boy who presented with repetitive episodes of torticollis. Open-mouth odontoid radiograph and computed tomographic (CT) scan gave a diagnosis in ARRS, based on its characteristic imaging findings. The child was admitted multiple times for continuous halter traction in the first 6 months after symptom onset. He also experienced a temporary complication from an overcorrection with correcting neck bracing. Seven months after symptom onset, this case was discussed by a multidisciplinary spine team and referred to chiropractic clinic. Despite persistent radiographic evidence of atlantoaxial instability, after 5 months of chiropractic treatment, the child was asymptomatic with nearly full range of neck movement. He also weaned off acetaminophen he had been taking over the past year. Incidentally, bilateral gynecomastia was discovered at the surveillance after treatment. The incidental finding of innocent gynecomastia, even if common in preteen boys, brings up the topic of acetaminophen’s effects on the regulation of sex hormones that was previously overlooked.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Atlantoaxial Rotatory Subluxation in a 10-Year-Old Boy

Chu

Chakkaravarthy

et al. 2020

Clin Med�Insights�Arthritis�Musculoskelet Disord

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“…Atlantoaxial rotatory subluxation is a dislocation of the C1-C2 joint that develops after unilateral injury of the transverse ligament which is characterized by patients' complaints about widespread neck pain (3). The most important symptom of torticollis is that the head turns to one side.…”

Section: Discussionmentioning

confidence: 99%

Torticollis Secondary to a Posterior Fossa Tumor: A Case Report

Göztepe¹,

Güldağ²,

Akıncı³

et al. 2019

tmsj

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Aims: Torticollis secondary to a posterior fossa tumor is a rare condition that is mostly seen in pediatric patients. In this case report, it is aimed to present a 23-month-old male patient with a posterior fossa tumor that presents the symptoms of torticollis. Case Report: A 23-month-old male patient was admitted to the hospital with a history of a restricted range of motion in his neck and leaning to his left side while sitting. Physical examination of the patient revealed acute onset of atlantoaxial rotatory subluxation findings therefore, the initial diagnosis was Grisel's Syndrome. Later, a cranial magnetic resonance imaging revealed a mass which was seen in the posterior fossa. The mass was considered as the cause of the torticollis. Conclusion: This case report shows the importance of the differential diagnosis of torticollis. Posterior fossa tumors should not be overlooked while searching for the cause of torticollis.

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“…They stated that patients presenting acutely without neurologic defisits can benefit from collar theraphy while the subacute ones are more prone to surgical theraphy [25]. Ciftdemir et al also reported case series of 8 patients in 2012 and professed that non-operative treatment is successful in patients with an early diagnosis [26]. Chechic et all represented their 5 pediatric cases in 2012.…”

Section: Cmjmentioning

confidence: 99%

A diagnose not to miss: Rotatory Atlantoaxial subluxation in emergency service

Ocak¹,

Ocak²

2016

Cumhuriyet Med J

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SUMMARYObjective: The objective of this study is to take attention to atlantoaxial subluxations especially in pediatric population that may be misdiagnosed in the emergency services easily. When diagnosed early in the emergency services, it may be corrected with ease and the treatment is more likely to be conservative. Method:Seven patients with atlantoaxial rotatory subluxation (AARS), between ages of 5 and 13, who admitted to our emergency service between 1 July 2013 -1 September 2014 were examined retrospectively.Results: All patients were treated conservatively with bed rest, muscle relaxants and rigid cervical collar. None of them needed surgery. Conclusions:Atlantoaxial rotatory subluxation (AARS) is one of the main types of cervical spine anomalies seen in pediatric patients and is a rare condition that is often misdiagnosed and therefore incorrectly managed especially in emergency services. The diagnosis requires a high index of suspicion. Many pediatric cervical spine injuries can be treated with external immobilization and AARS is almost always reducible. Pediatric population is prone to upper spine injuries due t o ligamentous laxity and AARS should always be kept in mind especially in emergency services.

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Non-operative treatment in children and adolescents with atlantoaxial rotatory subluxation

Cited by 10 publications

References 11 publications

Atlantoaxial Rotatory Subluxation in a 10-Year-Old Boy

Atlantoaxial Rotatory Subluxation in a 10-Year-Old Boy

Torticollis Secondary to a Posterior Fossa Tumor: A Case Report

A diagnose not to miss: Rotatory Atlantoaxial subluxation in emergency service

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