Belzberg A J, Tranmer B I
Department of Clinical Neurosciences, Foothills Hospital, University of Calgary, Alberta, Canada.
J Neurosurg. 1991 Sep;75(3):478-82. doi: 10.3171/jns.1991.75.3.0478.
Traumatic atlanto-occipital dislocation is most often fatal. Consequently, there are only scattered case reports of patients surviving this injury, and treatment modalities are anecdotal and varied. The case of an 18-year-old woman who suffered an anterior atlanto-occipital dislocation as the result of a motor-vehicle accident is presented. Rigid posterior fixation and complete reduction of the dislocation were achieved using an anatomically contoured steel loop secured to the occiput and cervical vertebrae. The addition of cancellous bone to the graft afforded long-term stability. This operative treatment provided anatomical realignment of the dislocation and allowed early mobilization of the patient with the use of aggressive rehabilitation. Previously reported cases of patients surviving anterior atlanto-occipital dislocation are reviewed. The use of cervical traction, halo bracing, and operative stabilization is discussed.
创伤性寰枕关节脱位通常是致命的。因此，仅有少量关于此类损伤患者存活的病例报告，且治疗方式多为经验性且各不相同。本文介绍了一名18岁女性因机动车事故导致寰枕关节前脱位的病例。通过使用固定于枕骨和颈椎的解剖塑形钢环实现了脱位的坚强后路固定及完全复位。在植骨中添加松质骨可提供长期稳定性。这种手术治疗使脱位得以解剖复位，并通过积极康复使患者能够早期活动。对先前报道的寰枕关节前脱位存活患者的病例进行了回顾。讨论了颈椎牵引、头环支具及手术稳定化的应用。
