Kamakura Fuminori, Shimizu Shota, Shigenobu Keisuke, Yasuda Gaku, Ishigaki Yoshimasa, Goto Satoshi
Department of Orthopedic Surgery, Fujimi-Kogen Hospital, Fujimi-Kogen Medical Center, Fujimi, JPN.
Department of Orthopedic Surgery, Shinshu University School of Medicine, Matsumoto, JPN.
Cureus. 2024 Dec 3;16(12):e75051. doi: 10.7759/cureus.75051. eCollection 2024 Dec.
This study reports on an extremely rare case of non-traumatic atlantoaxial rotatory fixation (AARF) in an adult. Although there are numerous reports on traumatic AARF in adults, those on non-traumatic AARFs are limited. We present the case of a 25-year-old woman who developed neck pain with a limited range of motion (ROM) that began upon waking without any particular inducement. Physical examination showed a characteristic torticollis neck posture called the cock robin position. The patient exhibited severely limited neck mobility with no neurological deficits. Computed tomography (CT) revealed that the atlas was rotated to the right in relation to the axis, resulting in a diagnosis of AARF Fielding type 1. Conservative treatment was adopted by immobilizing the cervical spine using a soft neck collar. Four weeks post-treatment, all symptoms improved with no adverse complications. We present an extremely rare case of non-traumatic AARF in an adult patient. As surgical treatment may be necessary if the diagnosis is delayed, appropriate diagnosis and treatment should be made in the early stages.
本研究报告了一例极其罕见的成人非创伤性寰枢椎旋转固定（AARF）病例。虽然有许多关于成人创伤性AARF的报道，但关于非创伤性AARF的报道有限。我们呈现了一名25岁女性的病例，她在无任何特殊诱因的情况下醒来后出现颈部疼痛且活动范围（ROM）受限。体格检查显示出一种典型的斜颈颈部姿势，称为知更鸟姿势。患者颈部活动严重受限，无神经功能缺损。计算机断层扫描（CT）显示寰椎相对于枢椎向右旋转，导致诊断为Fielding 1型AARF。采用软颈托固定颈椎进行保守治疗。治疗四周后，所有症状均有改善，无不良并发症。我们呈现了一例成人患者极其罕见的非创伤性AARF病例。由于如果诊断延迟可能需要手术治疗，因此应在早期进行适当的诊断和治疗。
