Ahuja Kaustubh, Kandwal Pankaj, Singh Sanny, Jain Rohit
Department of Orthopaedic Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
J Orthop Case Rep. 2019;9(4):80-83. doi: 10.13107/jocr.2019.v09.i04.1490.
In atlantoaxial context, spondyloptosis has been defined as a situation when both the inferior facets of atlas are fixed anterior to the superior facets of axis. Such an injury scenario is a rare presentation with a few reported cases in available literature.
We present a case of post-traumatic anterior atlantoaxial dislocation or spondyloptosis associated with a Type 2 odontoid fracture in an adult patient who presented to us 3 months after injury. After failed attempts of closed reduction with traction, open reduction and posterior instrumentation with fusion were done using joint remodeling technique. 6-month follow-up showed completely reduced facet joints with near complete fusion.
Long-standing complete C1-C2 dislocations pose a challenge for a surgeon because of the associated difficulty in joint reduction. Joint remodeling and manipulation have antiquated transoral odontoidectomy as excellent results have been achieved by direct posterior approach.
在寰枢椎情况下,椎体滑脱被定义为寰椎下关节面固定于枢椎上关节面前方的一种情况。这种损伤情况较为罕见,现有文献中报道的病例较少。
我们报告一例成年患者,在受伤3个月后前来就诊,其患有创伤后寰枢椎前脱位或椎体滑脱,并伴有Ⅱ型齿状突骨折。在尝试牵引闭合复位失败后,采用关节重塑技术进行了切开复位及后路器械融合术。6个月的随访显示关节面完全复位,且接近完全融合。
长期存在的C1-C2完全脱位给外科医生带来了挑战,因为关节复位存在相关困难。关节重塑和手法操作已使经口齿状突切除术过时,因为直接后路手术已取得了优异的效果。