Anania Pasquale, Pavone Piero, Pacetti Mattia, Truffelli Monica, Pavanello Marco, Ravegnani Marcello, Consales Alessandro, Cama Armando, Piatelli Gianluca
Neurosurgery, Pediatric Hospital Giannina Gaslini, University of Genoa, Genoa, Italy; Neurosurgery, Department of Neurosciences (DINOGMI), Policlinico San Martino, University of Genoa, Genoa, Italy.
Department of Pediatrics, University Hospital B Policlinico-Vittorio Emanuele, Catania, Italy; Department of Pediatrics, AOU Policlinico-Vittorio Emanuele, University of Catania, Catania, Italy.
World Neurosurg. 2019 May;125:374-382. doi: 10.1016/j.wneu.2019.02.035. Epub 2019 Feb 22.
Nontraumatic atlantoaxial subluxation, also known as Grisel syndrome, is a rare disease that usually affects children. The typical presentation is torticollis in patients with a history of surgical operations or airway infections.
We describe 5 patients with Grisel syndrome, referring to medical care for a torticollis, a few weeks after an airway infection, with no trauma associated. Radiologic confirmation of the diagnosis, with computed tomography and magnetic resonance imaging studies, was carried out.
The patients were treated with external immobilization for 3 months, followed by surgical fixation in the case of recurrence after collar removal or inveterate subluxation. We performed a review of the literature to define the best management of this disease.
Management of Grisel syndrome depends on the degree of subluxation basing on the Fielding and Hawkins classification. The initial nonsurgical management consists of close reduction and immobilization. Surgical fixation is indicated in cases of conservative treatment failure.
非创伤性寰枢椎半脱位，也称为格里斯尔综合征，是一种罕见疾病，通常影响儿童。典型表现为有手术史或气道感染史的患者出现斜颈。
我们描述了5例格里斯尔综合征患者，他们在气道感染后几周因斜颈就医，无相关创伤。通过计算机断层扫描和磁共振成像研究进行了诊断的影像学确认。
患者接受了3个月的外部固定治疗，若去除颈托后复发或存在顽固性半脱位则进行手术固定。我们对文献进行了综述以确定该疾病的最佳治疗方法。
格里斯尔综合征的治疗取决于基于菲尔丁和霍金斯分类的半脱位程度。初始非手术治疗包括密切复位和固定。保守治疗失败的病例需进行手术固定。
