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World Neurosurg. 2018 Feb;110:106-114. doi: 10.1016/j.wneu.2017.11.005. Epub 2017 Nov 10.

Atlanto-Occipital Rotatory Dislocation: A Case Report and Systematic Review.

Author information

1
Section of Neurosurgery, Hospiten, Puerto Vallarta, Jalisco, Mexico. Electronic address: larob@prodigy.net.mx.
2
San Diego Center for Spinal Disorders, La Jolla, California, USA.
3
Section of Neurosurgery, Hospital San Javier, Guadalajara, Jalisco, Mexico.

Abstract

BACKGROUND:

Atlanto-occipital rotatory dislocation (AORD) has rarely been reported in the literature; for this reason, the clinicoradiologic characteristics of this injury are not well described.

METHODS:

We describe the case of a 67-year-old man who sustained a cervical spine trauma. He reported only neck pain and was neurologically intact. A computed tomography scan showed a rotatory displacement of the atlanto-occipital joints associated with a widened condylar-C1 interval; in addition, magnetic resonance imaging showed injuries to the stabilizing ligaments of this area. A systematic literature review was also performed to identify previous cases of patients with AORD.

RESULTS:

The patient was treated with craniocervical fixation from occipital to C1, achieving a good outcome. The literature review yielded 9 cases of patients with AORD. Compared with patients with atlanto-occipital dislocation, patients with rotatory dislocations have a less severe degree of displacement of the atlanto-occipital joints and better clinical outcome.

CONCLUSIONS:

Compared with previously classified atlanto-occipital dislocations, AORD is an independent and unique variation. AORD presents with different biomechanical, clinicoradiologic, and prognostic characteristics and represents an important addition to the spectrum of atlanto-occipital dislocation injuries.

KEYWORDS:

Atlanto-occipital dislocation; Atlanto-occipital dissociation; Atlanto-occipital rotatory dislocation; Occipitoatlantal dislocation

PMID:
29133003
DOI:
10.1016/j.wneu.2017.11.005
[Indexed for MEDLINE]

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