Sundseth Jarle, Berg-Johnsen Jon, Skaar-Holme Sigrun, Züchner Mark, Kolstad Frode
Department of Neurosurgery, Oslo University Hospital, Rikshospitalet, Norway.
Tidsskr Nor Laegeforen. 2013 Mar 5;133(5):519-23. doi: 10.4045/tidsskr.11.1540.
A rare, but important cause of torticollis in children is atlantoaxial rotatory fixation. If the patient remains undiagnosed for more than three months, surgery is generally the only therapeutic alternative. In this article we present our experiences of surgical treatment of late-diagnosed atlantoaxial rotatory fixation in children.
This article is based on a review of the case notes of patients who underwent surgery for atlantoaxial rotatory fixation in the Department for Neurosurgery at Oslo University Hospital, Rikshospitalet, during the period 2004-10.
The material sample consists of six children aged from seven to 14 years. Five had suffered minor trauma to the upper neck region, while one had had an upper respiratory tract infection. The diagnosis was made 5-36 months after the onset of symptoms. In three of the patients, an attempt was made at closed reduction without success. A CT scan one year postoperatively showed a normal position of the atlantoaxial joint in two patients and partial reduction in three. In the sixth patient there was bone fusion at the time of the operation, and open reduction was unsuccessful. All six patients had reduced rotational movement of the neck at the one-year check-up.
All our patients were diagnosed more than five months after the onset of symptoms. Full or partial reduction was achieved in five of the six.
儿童斜颈的一个罕见但重要的病因是寰枢椎旋转固定。如果患者在超过三个月的时间里未被诊断出来，手术通常是唯一的治疗选择。在本文中，我们介绍了对儿童晚期诊断的寰枢椎旋转固定进行手术治疗的经验。
本文基于对2004年至2010年期间在奥斯陆大学医院里克斯胡斯医院神经外科接受寰枢椎旋转固定手术的患者病历的回顾。
样本包括6名年龄在7至14岁之间的儿童。5名儿童上颈部区域受过轻微创伤，1名儿童曾患过上呼吸道感染。症状出现后5至36个月做出诊断。3名患者尝试进行闭合复位但未成功。术后一年的CT扫描显示，2名患者的寰枢关节位置正常，3名患者部分复位。在第6名患者中，手术时存在骨融合，切开复位未成功。所有6名患者在一年检查时颈部旋转运动均减少。
我们所有的患者在症状出现后超过五个月才被诊断出来。6名患者中有5名实现了完全或部分复位。
