Combined occipital-cervical and atlantoaxial disassociation without neurologic injury: case report and review of the literature.
Spine (Phila Pa 1976)
; 35(8): E316-21, 2010 Apr 15.
Article
em En
| MEDLINE
| ID: mdl-20308946
ABSTRACT
STUDY DESIGN:
Case report and literature review.OBJECTIVE:
To discuss the diagnosis, limitations, and treatment of combined occipital-cervical and atlantoaxial disassociation with normal neurologic function. SUMMARY OF BACKGROUND DATA Injuries to the craniocervical junction can lead to devastating neurologic deficits. Occipital-cervical disassociation is a well-documented injury pattern that can lead to pain, spinal cord injury, and death. Early diagnosis and treatment can preserve neurologic function. Combined injuries to both the occipital-cervical and atlantoaxial segments are less common and, to date, have only been described with severe neurologic injury.METHODS:
Retrospective review of a case. Literature review was performed through Medline and Pubmed searches.RESULTS:
This is the first case to present a combined occipital-cervical and atlantoaxial disassociation with a neurologically intact patient. Initial physical examination was limited, but early imaging revealed evidence of instability. Early diagnosis and early (< 24) surgical stabilization was performed with no complications and neurologic preservation. One-year follow-up visit revealed normal neurologic examination with neck pain VAS = 2/10 and neck disability index = 6.CONCLUSION:
Combined injuries to the occipital-cervical and atlantoaxial can result in upper cervical instability. Despite previous reports, neurologic preservation remains a possibility in this injury pattern. Limitations in physical examination and radiographic imaging persist, but early diagnosis and surgical stabilization may improve neurologic outcomes.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Articulação Atlantoaxial
/
Fraturas da Coluna Vertebral
/
Luxações Articulares
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Screening_studies
Idioma:
En
Revista:
Spine (Phila Pa 1976)
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
Estados Unidos