Tarantino Roberto, Donnarumma Pasquale, Marotta Nicola, Missori Paolo, Viozzi Ilaria, Landi Alessandro, Delfini Roberto
Department of Neurosurgery, Sapienza University of Rome.
Neurol Med Chir (Tokyo). 2014;54(5):413-6. doi: 10.2176/nmc.cr2012-0431. Epub 2013 Nov 8.
Atlanto Axial Rotatory Dislocations (AARDs) are a heterogeneous group of post-traumatic pathologies typical of the pediatric age, and rare in adults. We describe the case of a 34-year-old woman, developing Atlanto Axial Rotatory Fixation (AARF) after a generalized tonic-clonic epileptic seizure, an extremely rare traumatic cause never described in literature. AARF was detected only 1 month after the accident and nonsurgical treatment was attempted at the beginning. The patient underwent surgery only 2 months after the accident. The best treatment should be conservative reduction within 1 month; when it is not possible, it is advisable to perform surgery as soon as possible. C1-C2 fixation with Harm's technique is the gold standard for fixed luxations. Delay of treatment makes intraoperative reduction more difficult and increase the establishment of the chronic permanent change of neck muscles and ligaments.
寰枢椎旋转性脱位（AARDs）是一组创伤后病理状况的异质性疾病，典型于儿童期，在成人中罕见。我们描述了一名34岁女性的病例，她在全身性强直阵挛性癫痫发作后发生了寰枢椎旋转性固定（AARF），这是一种极其罕见的创伤原因，文献中从未描述过。AARF在事故发生后1个月才被发现，起初尝试了非手术治疗。患者在事故发生后仅2个月就接受了手术。最佳治疗应在1个月内进行保守复位；如果不可能，则建议尽快进行手术。采用哈姆斯技术进行C1-C2固定是固定性脱位的金标准。治疗延迟会使术中复位更加困难，并增加颈部肌肉和韧带慢性永久性改变的发生率。
