Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Parel, Mumbai, India.
J Neurosurg Spine. 2011 Jan;14(1):3-9. doi: 10.3171/2010.9.SPINE1010. Epub 2010 Dec 17.
The authors report their experience with 14 children in whom acute torticollis or a fixed flexion neck deformity developed. Other than neck deformity, there was no other significant functional or neurological symptom. Although several possible pathogenetic factors have been speculated, the exact cause remains unknown. Conservative observation and/or attempts at closed reduction failed to effect deformity resolution. Investigations revealed "locking" of facets that resulted in rotatory or translatory atlantoaxial dislocation depending on the nature of facet dislocation. The management issues in such cases are evaluated. The authors discuss the validity of atlantoaxial facet distraction and manipulation/reduction and fixation under direct visualization. In all cases recovery from neck deformity was significant immediately after surgery. The deformity resolution was sustained during a mean follow-up period of 23 months (range 3-52 months), although the range of neck movements remained marginally restricted. The craniovertebral realignment is demonstrated by images and clinical photographs.
作者报告了 14 例儿童出现急性斜颈或固定性屈颈畸形的经验。除了颈部畸形外，没有其他明显的功能或神经症状。尽管推测了几个可能的发病因素，但确切原因仍不清楚。保守观察和/或尝试闭合复位未能使畸形得到缓解。检查发现小关节“锁定”，导致旋转或平移寰枢椎脱位，具体取决于小关节脱位的性质。评估了此类情况下的治疗问题。作者讨论了在直接可视化下进行寰枢关节小关节牵开和手法复位/固定的有效性。所有病例在手术后立即从颈部畸形中得到显著恢复。畸形缓解在平均随访 23 个月（3-52 个月）期间持续，尽管颈部活动范围仍略有受限。通过图像和临床照片显示颅颈重新对齐。
