Georgopoulos G, Pizzutillo P D, Lee M S
J Bone Joint Surg Am. 1987 Mar;69(3):429-36.
We are reporting the cases of five patients who had occipito-atlantal instability, a rare condition that may be due to either trauma or congenital abnormalities. In three of the patients the instability was secondary to trauma. The clinical and neurological manifestations were varied and included cardiorespiratory arrest, motor weakness, quadriplegia, torticollis, pain in the neck, vertigo, and projectile vomiting. All of the patients underwent posterior arthrodesis of the occiput to the first or second cervical vertebra. In the patients who had trauma-related instability, surgery was performed when immobilization in a cast failed to stabilize the spine; in the patients who had a congenital abnormality, arthrodesis was indicated because of persistent symptoms and the potential for catastrophe with minor trauma. Based on our experience, we recommend surgical stabilization by posterior arthrodesis when this form of instability of the cervical spine is diagnosed.
我们报告了5例枕寰关节不稳定患者的病例，这是一种罕见的疾病，可能由创伤或先天性异常引起。其中3例患者的不稳定继发于创伤。临床和神经学表现各不相同，包括心肺骤停、运动无力、四肢瘫痪、斜颈、颈部疼痛、眩晕和喷射性呕吐。所有患者均接受了枕骨至第一或第二颈椎的后路融合术。对于与创伤相关的不稳定患者，当石膏固定未能稳定脊柱时进行手术；对于先天性异常患者，由于症状持续存在以及轻微创伤可能导致灾难性后果，因此建议进行融合术。根据我们的经验，当诊断出这种形式的颈椎不稳定时，我们建议通过后路融合术进行手术稳定。
