Section of Neurosurgery, Hospiten, Puerto Vallarta, Jalisco, Mexico.
San Diego Center for Spinal Disorders, La Jolla, California, USA.
World Neurosurg. 2018 Feb;110:106-114. doi: 10.1016/j.wneu.2017.11.005. Epub 2017 Nov 10.
Atlanto-occipital rotatory dislocation (AORD) has rarely been reported in the literature; for this reason, the clinicoradiologic characteristics of this injury are not well described.
We describe the case of a 67-year-old man who sustained a cervical spine trauma. He reported only neck pain and was neurologically intact. A computed tomography scan showed a rotatory displacement of the atlanto-occipital joints associated with a widened condylar-C1 interval; in addition, magnetic resonance imaging showed injuries to the stabilizing ligaments of this area. A systematic literature review was also performed to identify previous cases of patients with AORD.
The patient was treated with craniocervical fixation from occipital to C1, achieving a good outcome. The literature review yielded 9 cases of patients with AORD. Compared with patients with atlanto-occipital dislocation, patients with rotatory dislocations have a less severe degree of displacement of the atlanto-occipital joints and better clinical outcome.
Compared with previously classified atlanto-occipital dislocations, AORD is an independent and unique variation. AORD presents with different biomechanical, clinicoradiologic, and prognostic characteristics and represents an important addition to the spectrum of atlanto-occipital dislocation injuries.
寰枕旋转脱位（AORD）在文献中鲜有报道；因此，这种损伤的临床影像学特征尚未得到很好的描述。
我们描述了一位 67 岁男性的颈椎外伤病例。他仅报告颈部疼痛，且神经功能完整。计算机断层扫描显示寰枕关节旋转性移位，伴有髁突 C1 间距增宽；此外，磁共振成像显示该区域稳定韧带损伤。我们还进行了系统的文献复习，以确定以前有 AORD 患者的病例。
患者接受了从枕骨到 C1 的颅颈固定治疗，取得了良好的效果。文献复习共纳入 9 例 AORD 患者。与寰枕关节脱位患者相比，旋转脱位患者寰枕关节的移位程度较轻，临床预后较好。
与先前分类的寰枕关节脱位相比，AORD 是一种独立且独特的变异。AORD 具有不同的生物力学、临床影像学和预后特征，是寰枕关节脱位损伤谱中的一个重要补充。
