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Research ArticleCervical Spine

Neglected Traumatic Atlantoaxial Rotatory Dislocation in Adult: A Case Report

RAGHAV SINGLA, NIVEDITHA MANJUNATH, RAVI SHARMA and SHASHWAT MISHRA
International Journal of Spine Surgery February 2020, 14 (1) 46-52; DOI: https://doi.org/10.14444/7006
RAGHAV SINGLA
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi
MCH
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NIVEDITHA MANJUNATH
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi
MBBS
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RAVI SHARMA
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi
MBBS
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SHASHWAT MISHRA
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi
MCH
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    Figure 1

    (a) Preoperative clinical photograph showing “cock robin” position and (b) immediately postoperative clinical photograph showing resolution of neck tilt. (c–e) Postoperative images at 2 years show no residual deformity and minimal restriction of rotation.

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    Figure 2

    Preoperative MRI: (a) Coronal scans showing lateral tilt. (b) T2 weighted axial scans showed intact transverse alar ligament.

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    Figure 3

    Preoperative x-ray: (a) Note eccentric position of the odontoid. (b) Lateral x-ray showing rotation at C1-2 with elliptical appearance of the C1 arch.

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    Figure 4

    (a) Preoperative computed tomography angiography with 3-dimensional recon showing atlantoaxial rotatory dislocations. (b) Parasagittal view showing dislocation of facet joints. (c) Axial view showing maintained atlanto-dental interval with rotatory atlanto-axial dislocation.

  • Figure 5
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    Figure 5

    (a) Initial exposure depicting severe rotation of sub-axial spine in relation to C1. (b) Following opening of joint spaces C1-2 realignment noted. (c) Postoperative computed tomography scan.

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    Figure 6

    Postoperative x-ray images at 2 years in extension, neutral, and flexion.

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    Figure 7

    Postoperative MRI images at 3 years: (a) Sagittal scans of brainstem. (b) T2 weighted axial scans at foramen magnum level. (c) T2 weighted axial scans at C2 level.

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International Journal of Spine Surgery
Vol. 14, Issue 1
1 Feb 2020
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Neglected Traumatic Atlantoaxial Rotatory Dislocation in Adult: A Case Report
RAGHAV SINGLA, NIVEDITHA MANJUNATH, RAVI SHARMA, SHASHWAT MISHRA
International Journal of Spine Surgery Feb 2020, 14 (1) 46-52; DOI: 10.14444/7006

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Neglected Traumatic Atlantoaxial Rotatory Dislocation in Adult: A Case Report
RAGHAV SINGLA, NIVEDITHA MANJUNATH, RAVI SHARMA, SHASHWAT MISHRA
International Journal of Spine Surgery Feb 2020, 14 (1) 46-52; DOI: 10.14444/7006
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Keywords

  • atlantoaxial dislocations
  • atlantoaxial rotatory dislocations
  • atlantoaxial rotatory fixation
  • Fielding type 1 AARD

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