| Combined occipital-cervical and atlantoaxial disassociation without neurologic injury: case report and review of the literature. | |
| | |
MedLine Citation:
|
PMID: 20308946 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
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. |
| | |
Authors:
|
Erica Bisson; Alison Schiffern; Michael D Daubs; Darrel S Brodke; Alpesh A Patel |
Related Documents
:
|
16691416 - Retropharyngeal lymph node metastasis from olfactory neuroblastoma: a report of two cases. 15520706 - Physiologic anterior subluxation: case report of occurrence at c5 to c6 and c6 to c7 sp... 1724936 - Degeneration and ossification of the yellow ligament in unstable spine. 1484306 - Associated cervical schwannoma and dorsal meningioma. case report and review of the lit... 21164286 - Interobserver variability in the diagnosis of crypt dysplasia in barrett esophagus. 12603996 - Viral encephalitis in england, 1989-1998: what did we miss? |
Publication Detail:
|
Type: Case Reports; Journal Article; Review |
Journal Detail:
|
Title: Spine Volume: 35 ISSN: 1528-1159 ISO Abbreviation: Spine Publication Date: 2010 Apr |
Date Detail:
|
Created Date: 2010-04-16 Completed Date: 2010-07-12 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 7610646 Medline TA: Spine (Phila Pa 1976) Country: United States |
Other Details:
|
Languages: eng Pagination: E316-21 Citation Subset: IM |
Affiliation:
|
Department of Neurosurgery, Lahey Clinic, Boston MA, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Accidents, Traffic Adolescent Atlanto-Axial Joint / injuries*, pathology, radiography Atlanto-Occipital Joint / injuries, pathology, radiography Axis / injuries, pathology, radiography Cervical Atlas / injuries, pathology, radiography Dislocations / diagnosis*, nursing, surgery* Early Diagnosis Emergency Treatment / methods, standards Female Humans Internal Fixators Ligaments / injuries, pathology, radiography Occipital Bone / injuries, pathology, radiography Pelvis / injuries Prosthesis Implantation / instrumentation, methods Radiology / methods, standards Retrospective Studies Skull Fracture, Basilar / diagnosis, nursing, surgery Spinal Cord Compression / etiology, physiopathology, prevention & control Spinal Fractures / diagnosis*, nursing, surgery* Spinal Fusion / instrumentation, methods Spleen / injuries Tomography, X-Ray Computed / methods, standards Treatment Outcome Zygapophyseal Joint / injuries, pathology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Nerve root sedimentation sign: evaluation of a new radiological sign in lumbar spinal stenosis.
Next Document: Multiple Lumbar Pedicle Fractures in Osteopetrosis: A Case Report.