Kim Jae Hong, Kim Jung Hee, Jang Se Youn, Kong Min Ho
Department of Neurosurgery, Seoul Medical Center, Seoul, Korea.
Korean J Spine. 2013 Sep;10(3):192-4. doi: 10.14245/kjs.2013.10.3.192. Epub 2013 Sep 30.
Occipito-atlantalrotatory subluxation that occurs in conjunction with atlanto-axial rotator fixation is extremely rare. The common clinical characteristics are painful torticollis and cock robin position presented with the head tilted to one side and rotated to the other side. The object of this report is to emphasize that AARF combined with OARF may be caused by a variety of conditions, to be must need algorithm for proper management, apparently. A torticollis patient who had cerebral palsy presented with severe nuchal pain and wryneck for a long period. The patient had a history of fallen down 16 years ago which caused severe nuchal pain. The conservative management had failed to correct the deformity and instability. we decided to operate using occiput-C1-C2 arthrodesis and C3-4-5 bilateral screw fixation for reinforcement. Now he doesn't have neurologic deficit and shows good outcome enough to sustain his head, not using his hands, in his daily life.
与寰枢椎旋转固定同时发生的枕寰关节旋转半脱位极为罕见。常见的临床特征是疼痛性斜颈以及呈“知更鸟姿势”，即头部向一侧倾斜并向另一侧旋转。本报告的目的是强调寰枢椎旋转固定合并枕寰关节旋转半脱位可能由多种情况引起，显然需要合适的处理算法。一名患有脑瘫的斜颈患者长期存在严重的颈部疼痛和歪颈。该患者16年前有跌倒史，导致严重的颈部疼痛。保守治疗未能纠正畸形和不稳定。我们决定采用枕骨-第一颈椎-第二颈椎融合术及第三颈椎-第四颈椎-第五颈椎双侧螺钉固定进行强化手术。现在他没有神经功能缺损，并且在日常生活中能取得足以支撑头部而无需用手辅助的良好效果。
