Spine · 2007
Post-traumatic atlantoaxial rotatory fixation in an adult: a case report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Kim Yeon-Seong, Lee Jung-Kil, Moon Sung-Jun, Kim Soo-Han
Аннотация
STUDY DESIGN: A case report.
OBJECTIVE: To describe an interesting patient who underwent open reduction and C1-C2 transpedicular screw fixation with interspinous wiring due to high-riding vertebral artery.
SUMMARY OF BACKGROUND DATA: Atlantoaxial rotatory fixation (AARF) is a rare complication found most frequently after trauma in children and young adults; the clinical diagnosis is difficult and often made late.
METHODS: We report a case of post-traumatic AARF associated with a facet fracture in an adult. Reduction proved difficult to obtain by skull traction and gentle manipulation. Therefore, after open reduction under general anesthesia, we performed C1-C2 transpedicular screw fixation with posterior wiring to avoid vertebral artery injury due to high-riding transverse foramen at the C2 vertebra.
RESULTS: The normal atlantoaxial relation was restored and the torticollis resolved. The patient remains neurologically intact and has radiographic documentation of fusion.
CONCLUSION: Although technically demanding, C1-C2 transpedicular screw fixation combined with interspinous bone graft wiring after open reduction may be an alternative treatment option if conservative treatment fails to reduce AARF.
OBJECTIVE: To describe an interesting patient who underwent open reduction and C1-C2 transpedicular screw fixation with interspinous wiring due to high-riding vertebral artery.
SUMMARY OF BACKGROUND DATA: Atlantoaxial rotatory fixation (AARF) is a rare complication found most frequently after trauma in children and young adults; the clinical diagnosis is difficult and often made late.
METHODS: We report a case of post-traumatic AARF associated with a facet fracture in an adult. Reduction proved difficult to obtain by skull traction and gentle manipulation. Therefore, after open reduction under general anesthesia, we performed C1-C2 transpedicular screw fixation with posterior wiring to avoid vertebral artery injury due to high-riding transverse foramen at the C2 vertebra.
RESULTS: The normal atlantoaxial relation was restored and the torticollis resolved. The patient remains neurologically intact and has radiographic documentation of fusion.
CONCLUSION: Although technically demanding, C1-C2 transpedicular screw fixation combined with interspinous bone graft wiring after open reduction may be an alternative treatment option if conservative treatment fails to reduce AARF.
Предметные рубрики MeSH
Accidental FallsAdultAtlanto-Axial JointAxis, Cervical VertebraBone ScrewsBone TransplantationBone WiresFracture Fixation, InternalFractures, ClosedHumansJoint DislocationsMalePostoperative ComplicationsRadiography, InterventionalRotationSpinal FracturesSpinal FusionTomography, X-Ray ComputedTorticollisVertebral Artery