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Research ArticleCervical Spine

Neglected Traumatic Atlantoaxial Rotatory Dislocation in Adult

SINGLA RAGHAV, MANJUNATH NIVEDITHA, SHARMA RAVI and MISHRA SHASHWAT
International Journal of Spine Surgery December 2019, 13 (6) 531-535; DOI: https://doi.org/10.14444/6071
SINGLA RAGHAV
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
MCH
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MANJUNATH NIVEDITHA
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
MBBS
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SHARMA RAVI
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
MBBS
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MISHRA SHASHWAT
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
MCH
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    Figure 1

    (a) Preoperative clinical photograph showing “cock robin” position and (b) immediate 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 magnetic resonance image: (a) Coronal scans showing lateral tilt. (b) T2 weighted axial scans showing intact transverse alar ligament (TAL).

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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 rotary disclocation. (b) Parasagittal view showing dislocation of facet joints. (c) Axial view showing maintained the anterior atlantodental interval with rotatory AAD.

  • Figure 5
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    Figure 5

    (a) Initial exposure depicting severe rotation of subaxial 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 magnetic resonance images at 3 years (a) Sagittal scans of brainstem (b) T2 weighted (T2W) axial scans at foramen magnum level (c) T2W axial scans at C2 level.

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International Journal of Spine Surgery
Vol. 13, Issue 6
1 Dec 2019
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Neglected Traumatic Atlantoaxial Rotatory Dislocation in Adult
SINGLA RAGHAV, MANJUNATH NIVEDITHA, SHARMA RAVI, MISHRA SHASHWAT
International Journal of Spine Surgery Dec 2019, 13 (6) 531-535; DOI: 10.14444/6071

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Neglected Traumatic Atlantoaxial Rotatory Dislocation in Adult
SINGLA RAGHAV, MANJUNATH NIVEDITHA, SHARMA RAVI, MISHRA SHASHWAT
International Journal of Spine Surgery Dec 2019, 13 (6) 531-535; DOI: 10.14444/6071
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  • atlantoaxial rotatory dislocations
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