Traumatic Atlanto-Occipital Dislocation: A Case Report

Muñoz-Mahamud, Ernesto; Combalía, Andrés; Bori, Guillem

doi:10.1177/230949901202000327

Cited by 4 publications

(2 citation statements)

References 22 publications

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“…Traumatic AOD results from high-energy impact to the craniovertebral junction, usually causing ligamentous injury with rupture of the tectorial membrane and alar ligaments [7,13,14,[17][18][19][20][21]. Our review confirmed that MVAs are the most commonly reported cause of AOD.…”

Section: Discussionsupporting

confidence: 69%

Prognostic factors in traumatic atlanto-occipital dislocation

Fard

Avila

Johnstone

et al. 2016

Journal of Clinical Neuroscience

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Section: Discussionsupporting

confidence: 69%

Prognostic factors in traumatic atlanto-occipital dislocation

Fard

Avila

Johnstone

et al. 2016

Journal of Clinical Neuroscience

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“…Neurologic deficits from AOD can range from normal neurological exam which is found in up to 20% of patients, to instant fatality ( 2 , 3 ). Initial screening lateral cervical radiograph is an acceptable first-line test, although more frequently cervical spine CT is the first imaging test done of the cervical spine.…”

Section: Discussionmentioning

confidence: 99%

Successful non-operative treatment of traumatic atlanto-occipital dislocation: a case report

Gertz,

Cornett,

Gannon

2023

J Spine Surg

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Background Traumatic atlanto-occipital dislocation (AOD) is most commonly treated with cranio-cervical fusion. We present a unique case in which a partial neurological recovery was made after non-operative treatment was done for AOD. Reports of non-operative treatment of this condition are rare in the literature. Case Description An 18-year-old male sustained a traumatic AOD and atlanto-axial dislocation. His injury was characterized by bony avulsion fractures of the occipital condyles bilaterally as well as atlanto-axial dissociation. Non-operative treatment was done because of his comorbidities, primarily his morbid obesity. He was treated in a hard cervical collar for 6 months. He showed radiographic evidence of healing after being treated non-operatively in a rigid cervical collar for 6 months. Follow up at 17 months showed a partial neurological recovery with ability to ambulate assisted with a walker. Conclusions Successful outcomes are possible with non-operative treatment of AOD. A predominant factor contributing to this patient’s successful outcome with non-operative management was likely related to the bony avulsion fractures he had which allowed bone to bone healing and settling of the fracture with gravity assisted reduction in a collar. Non-operative treatment may be considered in patients who are too unhealthy or unstable to undergo surgical intervention, although the standard of care remains surgical cranio-cervical fusion.

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