Technique for direct posterior reduction in irreducible atlantoaxial dislocation: Multi-planar realignment of C1–2

Salunke, Pravin; Sahoo, Sushanta K.; Khandelwal, Niranjan; Ghuman, Mandeep S.

doi:10.1016/j.clineuro.2015.01.025

Cited by 54 publications

(27 citation statements)

References 14 publications

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“…The alignment of C1-2 can be judged by the midpoint of the C1-C2 arch and the midline occipital ridge [9]. Therefore, removal of foramen magnum rim and C1 arch should be done only after fusion of the facets.…”

Section: Discussionmentioning

confidence: 99%

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Congenital C1-2 Lateral Translational Dislocation: Case Illustration with Pre- and Postoperative Imaging

Salunke

Sahoo²,

Deepak³

et al. 2016

Pediatr Neurosurg

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Background: Congenital atlantoaxial dislocation has been commonly described in the antero-posterior or vertical plane (basilar invagination). However, dislocation in the lateral translational plane due to congenital deformity is rare. Case Report: We present a case of a young male who presented with os odontoideum with C1-2 dislocation in the lateral plane along with antero-posterior dislocation. He was operated on through a midline posterior incision, and the C1-2 facet was manipulated so as to correct the dislocation in all planes. Conclusion: With os odontoideum, the C1-2 joints can exhibit movements that are out of the ordinary, even in the lateral translational plane. It suggests that the ligaments and joint capsule may weaken with time. Careful radiological evaluation helps in diagnosing this rare condition. An understanding of 3D facetal anatomy is important to achieve complete correction.

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Section: Discussionmentioning

confidence: 99%

“…The vertebral artery needs to be safeguarded during drilling and manipulation [2,8]. Further manipulation of facets and realignment of C1-2 can be achieved by manipulation of the rod with a long rod holder that acts like a lever [9]. …”

Section: Discussionmentioning

confidence: 99%

Congenital C1-2 Lateral Translational Dislocation: Case Illustration with Pre- and Postoperative Imaging

Salunke

Sahoo²,

Deepak³

et al. 2016

Pediatr Neurosurg

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show abstract

“…Further manipulation of C1–C2 joints were manipulated using rod holder and loosely fastened rod to realign facets. [8] The arteries were protected while drilling the C1–C2 joints and inserting the screws.…”

Section: Case Reportmentioning

confidence: 99%

Case of atlantoaxial dislocation with assimilated C1, absent posterior C2, butterfly C3, and fused subaxial cervical spine: Management dilemma with multiple segmentation and formation defects

2017

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Segmentation defects are often seen with congenital atlantoaxial dislocation (AAD) though an associated absence of posterior arch of C2 and butterfly C3 is rare. Apart from rarity, the combination of formation and segmentation defects adds to the management dilemma. We report a case of AAD with assimilated atlas, absent C2 posterior arch, C3 butterfly vertebra with floating posterior elements, and fused C4–C6. The child was managed by C1–C2 fusion alone with immediate symptomatic improvement. The presence of formation defects such as adjacent butterfly vertebra and absent posterior elements does not alter the management of AAD. Fusing the C1–C2 joints appears to be a balanced approach.

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“…A combination of brute force and gentle manoeuvring was required to realign the facets. The manipulation and realigning of lateral masses was achieved by using rod holders as levers and rotating the rods in clockwise direction [9]. Moving the rod holder in cranio-caudal plane brings about antero-posterior alignment.…”

Section: Why Posterior First?mentioning

confidence: 99%

‘Split and splayed C3’—traumatic lateral C2–3 dislocation without neurological deficits: unique case and its management

2017

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The saddle shape of the sub-axial cervical spine prevents such lateral dislocations. It is imperative to study the radiology in multiple planes to assess the 'multiplanar dislocation'. Correction is possible with proper planning and manipulation of facets and bodies using the available instrumentation. Though not obtained in this case, a preoperative MRI and a CT angiogram are important in surgery planning.

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Technique for direct posterior reduction in irreducible atlantoaxial dislocation: Multi-planar realignment of C1–2

Cited by 54 publications

References 14 publications

Congenital C1-2 Lateral Translational Dislocation: Case Illustration with Pre- and Postoperative Imaging

Congenital C1-2 Lateral Translational Dislocation: Case Illustration with Pre- and Postoperative Imaging

Case of atlantoaxial dislocation with assimilated C1, absent posterior C2, butterfly C3, and fused subaxial cervical spine: Management dilemma with multiple segmentation and formation defects

‘Split and splayed C3’—traumatic lateral C2–3 dislocation without neurological deficits: unique case and its management

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