| Non-traumatic subluxation of the atlanto-axial joint as rare form of aquired torticollis: Diagnosis and clinical features of the Grisel´s syndrome. | |
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MedLine Citation:
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PMID: 21178843 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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ABSTRACT: Study Design: Case report and review of the literatureObjective: We report a case of Grisel´s syndrom with a delayed diagnosis. The patients first presentation in our pediatric orthopedics department was two month after surgery (cochlea implantation) with a persistent torticollis. Radiographs revealed a subluxated atlantoaxial joint. We treated our patient with manual repositioning and calculated antibiotics, which lead to a restitutio ad integrum within a short time.Summary of Background Data: Grisel´s syndrome is synonymous with rare non-traumatic, rotational subluxation of the atlanto-axial joint (C1-C2). All formerly reported cases showed a clear association to infection or were related to head and neck surgery. Still, there is a lack of understanding about pathogenetic features and causative agents. In 1977 Fielding proposed a classification of the atlanto-axial subluxation and stage-related therapy was recommended.Methods: Our patient was a 11-year-old girl with a torticollis after insertion of a cochlea implant. After surgery, physiotherapy was performed because of her wryneck. As the symptoms did not improve, she was presented in our clinic. Our radiographs revealed a subluxated atlanto-axial joint.Results: In general anaesthesia we performed a manual repositioning and she was temporarily immobilized with a cervical collar for two weeks. Additionally we administered calculated antibiotics, although CRP and leucocytes were not elevated. The follow up showed a good repositioning within a short time.Conclusion: At least in this case, our treatment led to shorter recovery and avoidance of halo fixation. Our new therapeutic approach to patients with Grisel´s syndrom might lead to a shorter recovery. |
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Authors:
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H Pilge; P M Prodinger; D Bürklein; B M Holzapfel; J Lauen |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-2-1 |
Journal Detail:
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Title: Spine Volume: - ISSN: 1528-1159 ISO Abbreviation: - Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-2-3 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7610646 Medline TA: Spine (Phila Pa 1976) Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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