A Morphologically Atypical Case of Atlantoaxial Rotatory Subluxation
Journal of Korean Neurosurgical Society
; : 284-288, 2014.
Article
in En
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| ID: wpr-96984
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ABSTRACT
A rare case of atlantoaxial rotatory subluxation occurred after pediatric cervical spine surgery performed to remove a dumbbell-shaped meningioma at the level of the C1/C2 vertebrae. This case is classified as a post-surgical atlantoaxial rotatory subluxation, but has a very rare morphology that has not previously been reported. Although there are several reports about post-surgical atlantoaxial rotatory subluxation, an important point of this case is that it might be directly related to the spinal cord surgery in C1/C2 level. On day 6 after surgery, the patient presented with the Cock Robin position, and a computed tomography scan revealed a normal type of atlantoaxial rotatory subluxation. Manual reduction was performed followed by external fixation with a neck collar. About 7 months after the first surgery, the subluxation became severe, irreducible, and assumed an atypical form where the anterior tubercle of C1 migrated to a cranial position, and the posterior tubercle of C1 and the occipital bone leaned in a caudal direction. The pathogenic process suggested deformity of the occipital condyle and bilateral C2 superior facets with atlantooccipital subluxation. A second operation for reduction and fixation was performed, and the subluxation was stabilized by posterior fixation. We encountered an unusual case of a refractory subluxation that was associated with an atypical deformity of the upper spine. The case was successfully managed by posterior fixation.
Key words
Full text:
1
Index:
WPRIM
Main subject:
Spinal Cord
/
Spine
/
Congenital Abnormalities
/
Songbirds
/
Meningioma
/
Neck
/
Occipital Bone
Limits:
Humans
Language:
En
Journal:
Journal of Korean Neurosurgical Society
Year:
2014
Type:
Article