Abstract
Traumatic posterior atlantoaxial dislocation associated with odontoid fracture is extremely rare, with only eight cases reported thus far in the English literature. This report concerns a 47-year-old female who presented with considerable pain and stiffness in the neck without a neurologic deficit after injury due to a fall. Radiographs, computed tomography, and magnetic resonance imaging demonstrated a posterior dislocation of the atlas with respect to the axis with an odontoid fracture. No cord compression or intramedullary cord signal abnormalities were detected at the level of the atlantoaxial dislocation. A pedicle screw fixation/fusion was performed via a posterior approach following successful closed reduction.
References
Garber JN. Abnormalities of the atlas and axis vertebrae-congenital and traumatic. J Bone Joint Surg Am. 1964;46:1782–91.
Autricque A, Lesoin F, Villette L, Franz K, Pruvo JP, Jomin M. Fracture of the odontoid process and C1-C2 lateral luxation. Two cases. Ann Chir. 1986;40:397–400.
Fuentes S, Bouillot P, Palombi O, Ducolombier A, Desgeorges M. Traumatic atlantoaxial rotatory dislocation with odontoid fracture: case report and review. Spine. 2001;26:830–4. Phila Pa 1976.
Spoor AB, Diekerhof CH, Bonnet M, Oner FC. Traumatic complex dislocation of the atlantoaxial joint with odontoid and C2 superior articular facet fracture. Spine. 2008;33:E708–11. Phila Pa 1976.
Hopf S, Buchalla R, Elhöft H, Rubarth O, Borm W. Atypical dislocated dens fracture type II with rotational atlantoaxial luxation after a riding accident. Unfallchirurg. 2009;112:517–20.
Lenehan B, Guerin S, Street J, Poynton A. Lateral C1-C2 dislocation complicating a type II odontoid fracture. J Clin Neurosci. 2010;17:947–9.
Oh JY, Chough CK, Cho CB, Park HK. Traumatic atlantoaxial rotatory fixation with accompanying odontoid and C2 articular facet fracture. J Korean Neurosurg Soc. 2010;48:452–4.
Moreau PE, Nguyen V, Atallah A, Kassab G, Thiong’o MW, Laporte C. Traumatic atlantoaxial dislocation with odontoid fracture: a case report. Orthop Traumatol Surg Res. 2012;98:613–7.
Anderson LD, D’Alonzo RT. Fractures of the odontoid process of the axis. J Bone Joint Surg Am. 1974;56:1663–74.
Fielding JW, Hawkins RJ. Atlantoaxial rotatory fixation (Fixed rotatory subluxation of the atlantoaxial joint). J Bone Joint Surg Am. 1977;59:37–44.
Bohlman HH. Acute fractures and dislocations of the cervical spine. An analysis of three hundred hospitalized patients and review of the literature. J Bone Joint Surg Am. 1979;61:1119–42.
Carroll EA, Gordon B, Sweeney CA, Joy S, Connolly PJ. Traumatic atlantoaxial distraction injury: a case report. Spine. 2001;26:454–7. Phila Pa 1976.
Gleizes V, Jacquot FP, Signoret F, Feron JM. Combined injuries in the upper cervical spine: clinical and epidemiological data over a 14-year period. Eur Spine J. 2000;9:386–92.
Silbergeld DL, Laohaprasit V, Grady MS, Anderson PA, Winn HR. Two cases of fatal atlantoaxial distraction injury without fracture or rotation. Surg Neurol. 1991;35:54–6.
Myamoto H, Doita M, Nishida K, et al. Traumatic anterior atlantoaxial subluxation occurring in a professional rugby athlete. Case report and review of literature related tot atlantoaxial injuries in sports activities. Spine. 2004;29:E61–4. Phila Pa 1976.
Steel HH. Anatomical and mechanical consideration of the atlantoaxial articulation. J Bone Joint Surg Am. 1968;50:1481–2.
Ellis GL. Imaging of the atlas (C1) and axis (C2). Emerg Med Clin North Am. 1991;9:719–32.
Apfelbaum RI. Anterior screw fixation of odontoid fractures. In: Camins MB, O’Leary PF, editors. Diseases of the cervical spine. Baltimore: Williams and Wilkins; 1992. p. 603–8.
Gallie WE. Fractures and dislocations of the cervical spine. Am J Surg. 1939;3:495–9.
Brooks AL, Jenkins EB. Atlanto-axial arthrodesis by the wedge compression method. J Bone Joint Surg Am. 1978;60-A:279–84.
Lapsiwala SB, Anderson PA, Oza A, Resnick DK. Biomechanical comparison of four C1 to C2 rigid fixative technique: anterior transarticular, posterior transarticular, C1 to C2 pedicle, and C1 to C2 intralaminar screws. Neurosurgery. 2006;58:516–21.
Dailey AT, Hart D, Finn MA, Schmidt MH, Apfelbaum RI. Anterior fixation of odentoid fractures in an elderly population. J Neurosurg Spine. 2010;12:1–8.
Conflict of interest
No funds were received in support of this work. The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding authors
Additional information
Hao Meng, Yuan Gao, and Mo Li contributed equally to this work.
Rights and permissions
About this article
Cite this article
Meng, H., Gao, Y., Li, M. et al. Posterior atlantoaxial dislocation complicating odontoid fracture without neurologic deficit: a case report and review of the literature. Skeletal Radiol 43, 1001–1006 (2014). https://doi.org/10.1007/s00256-013-1809-y
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00256-013-1809-y