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Spontaneous rotatory atlantoaxial dislocation without neurological compromise in a child with Down syndrome: a case report.

ABSTRACT: Spontaneous atlantoaxial dislocation is a rare recognised complication of Down syndrome. In the majority of cases, dislocation takes place in an anteroposterior direction and is often associated with abnormalities of odontoid development or ossification. Rotatory atlantoaxial dislocation is extremely rare in Down syndrome and this is to our knowledge the first reported case in which modern imaging methods have been described; surface shaded reformats derived from a multislice CT scan were of fundamental importance in making the diagnosis.

SUBMITTER: Au-Yong I

PROVIDER: S-EPMC2525902 | biostudies-literature | 2008 Sep

REPOSITORIES: biostudies-literature

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Spontaneous rotatory atlantoaxial dislocation without neurological compromise in a child with Down syndrome: a case report.

Au-Yong Iain I Boszczyk Bronek B Mehdian Hossein H Kerslake Robert R

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 20080131

Spontaneous atlantoaxial dislocation is a rare recognised complication of Down syndrome. In the majority of cases, dislocation takes place in an anteroposterior direction and is often associated with abnormalities of odontoid development or ossification. Rotatory atlantoaxial dislocation is extremely rare in Down syndrome and this is to our knowledge the first reported case in which modern imaging methods have been described; surface shaded reformats derived from a multislice CT scan were of fun ...[more]

PMID: 18236086

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Recurrent traumatic atlantoaxial rotatory subluxation: Case report.

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Occult posterolateral rotatory dislocation of the elbow with olecranon fracture in a child: a case report.

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Current Trends in Management of Atlantoaxial Dislocation.

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C1-C2 pedicle screw fixation for adolescent with os odontoideum associated atlantoaxial dislocation and a compound reduction technique for irreducible atlantoaxial dislocation.

Project description: Not available

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Does alar ligament injury predict conservative treatment failure of atlantoaxial rotatory subluxation in adults: Case report and review of the literature.

Project description:IntroductionThe alar ligament is an important structure in restraining the rotational movement at the atlantoaxial joint. While bony fractures generally heal, rupture of ligaments may heal poorly in adults and often requires surgical stabilization. Atlantoaxial rotatory subluxation (AARS) is a rare injury in adults, and the prognostic importance of the presence of alar ligament injury with regard to the success of nonoperative management is unknown.Case presentationA 28-year-old woman presented after a traumatic Type I AARS without evidence of osseous injury, but MRI demonstrated evidence of unilateral alar ligament disruption. Initial conservative management with closed reduction and maintenance in a rigid cervical collar proved unsuccessful, with worsening pain and failure to maintain reduction. She subsequently underwent open reduction and surgical fixation of C1-C2, resulting in resolution of her pain and maintenance of alignment.DiscussionAlar ligament rupture may be a negative prognostic indicator in the success of nonoperative management of type I atlantoaxial rotatory subluxation. Additional study is warranted to better assess whether the status of the alar ligament should be considered an important factor in the management algorithm of type I AARS.

| S-EPMC8642488 | biostudies-literature

The retropharyngeal reduction plate for atlantoaxial dislocation: a finite element analysis.

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Transoral Atlantoaxial Reduction Plate (TARP) Technique for the Treatment of Irreducible Atlantoaxial Dislocation (IAAD) Caused by Old Odontoid Fracture.

Project description:Study designRetrospective case series study.ObjectivesThis study aimed to evaluate the clinical efficacy of TARP technique for treating IAAD caused by old odontoid fracture and assess the outcomes of patients who underwent TARP technique over 2 years of follow-up.MethodsBetween January 2005 and September 2017, 56 patients with IAAD caused by old odontoid fractures were treated with TARP technique. Patients' clinical, radiological, and surgical data were retrospectively analyzed. Radiological parameters included the atlantodental interval (ADI) and the space available for the spinal cord (SAC) were measured. Occipitocervical pain levels and neurologic status were evaluated with Visual Analog Scale (VAS) and Japanese Orthopaedic Association (JOA) score respectively. Degree of cervical dysfunction was assessed by Neck Disability Index (NDI). Fusion status was evaluated by images during the follow-ups.ResultsSurgeries for 56 cases were performed successfully with no injury to the spinal cord, nerve, or blood vessels. All patients achieved satisfactory reduction and fixation. Clinical symptomatic relief was obtained in all cases (100%). Patients were followed up for an average of 33.9 ± 9.6 months (ranged 24-60 months). Improvements in the postoperative ADI, SAC, VAS, JOA score and NDI were significant (P < .05). Besides, Bone fusion was observed in all patients. No hardware failure or re-dislocation occurred during the follow-up period.ConclusionsTARP technique is an effective procedure for the treatment of IAAD caused by old odontoid fracture, which can achieve complete release, satisfactory decompression, reduction and fixation, and reliable bone fusion through a single transoral approach.

| S-EPMC11559942 | biostudies-literature

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