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. 2021 Feb;14(s4):S5-S9.
doi: 10.14444/7157. Epub 2021 Jan 18.

A Case Report of Complete Dislocation of Atlantoaxial Joint due to a Traumatic and Pathological Axial Lesion

Xinwei Yuan  1 , Lun Wan  1 , Jiang Hu  1 , Wei Zhang  1
Affiliations

A Case Report of Complete Dislocation of Atlantoaxial Joint due to a Traumatic and Pathological Axial Lesion

Xinwei Yuan et al. Int J Spine Surg. 2021 Feb.

Abstract

Background: Atlantoaxial dislocation usually results in sudden death. The patient had never found any axial lesion before, and the atlantoaxial joint dislocation was caused by rotation of the neck due to discomfort of the neck. The patient was given surgical treatment after the rescue of respiratory and cardiac arrest during transportation, which was extremely rare and rarely reported.

Methods: A 62-year-old male patient presented with limited cervical mobility after a violent rotation of the neck due to neck discomfort. X-ray and computed tomography (CT) scan suggested atlantoaxial dislocation. Sudden respiratory and cardiac arrest during transportation was immediately followed by continuous cranial traction and successful occipital and neck fusion operation.

Results: After the successful rescue of endotracheal intubation, the patient was given continuous cranial traction. After the completion of CT scan, the patient was given occipital neck fusion, and 6 days after the surgery, the patient wore the skull-neck-thorax brace and walked freely.

Conclusion: Continuous cranial traction and posterior occipitocervical fusion are effective methods for treating axial pathological fracture with atlantoaxial dislocation.

Level of evidence: 5.

Keywords: atlantoaxial dislocation; cranial traction; occipitocervical fusion.

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Conflict of interest statement

Disclosures and COI: The authors received no funding for this study and report no conflicts of interest.

Figures

Figure 1
Figure 1
Preoperative anteroposterior x-ray (left) and preoperative lateral x-ray (right). Overlap of the atlas posterior arch with the axial odontoid can be seen on lateral radiographs.
Figure 2
Figure 2
Preoperative computed tomography scan sagittal view showed axial odontoid fracture. The fracture end is located in front of the axial body.
Figure 3
Figure 3
Complete reduction was seen in the sagittal and coronal positions after cranial traction.
Figure 4
Figure 4
Postoperation anteroposterior x-ray (left) and postoperation lateral x-ray (right).
See this image and copyright information in PMC

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