Survival after concurrent traumatic dislocation of the atlanto-occipital and atlanto-axial joints: a case report and review of the literature

Spine
Conor P KlewenoKevin J McGuire

Abstract

A case report of a patient who survived a traumatic disassociation of both atlanto-occipital and atlantoaxial joints. OBJECTIVE.: To describe a rare case of concurrent atlanto-occipital and atlantoaxial dislocation with a review of the related literature regarding occipitocervical dislocation. Cases of isolated atlanto-occipital or atlantoaxial dislocation have typically resulted in death or devastating neurologic deficit. Survival after the simultaneous dislocation at both joints is extremely rare. The initial evaluation, subsequent management, and surgical treatment of a 25-year-old male who sustained a concurrent dislocation of the atlantoaxial and atlanto-occipital joints from a motor vehicle collision are reported and the related literature is discussed. The patient was transferred to our hospital after initial stabilization according to Emergency Medical Service criteria and management based on the Advanced Trauma Life Support protocol. A complete (ASIA A) spinal cord injury was diagnosed on admission. Radiographic evaluation revealed dislocations of the atlanto-occipital and atlantoaxial joints. Subsequently, the patient underwent surgical stabilization with instrumented posterior fusion from the occiput to C5. Intraoper...Continue Reading

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Citations

Apr 14, 2010·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Heiko KollerWolfgang Hitzl
Aug 10, 2013·Neurosurgical Review·Alberto DebernardiMarco Cenzato
Mar 9, 2010·The Spine Journal : Official Journal of the North American Spine Society·Kristen E RadcliffJohn A Hipp
May 20, 2015·Cirugia y cirujanos·Tenoch Herrada-PinedaSalvador Manrique-Guzmán
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Dec 3, 2017·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Shiyao LiaoMichael Kreinest
Aug 12, 2015·Acute Medicine & Surgery·Kei MiyataEichi Narimatsu
Dec 21, 2012·Journal of Orthopaedic Surgery·Ernesto Munoz-MahamudGuillem Bori
May 20, 2017·Clinical Spine Surgery : a Spine Publication·Lingjun WangHuilin Yang

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