Thompson G H, Likavec M J, Archibald I, Rush T
J Pediatr Orthop. 1985 Mar-Apr;5(2):232-5.
Posttraumatic chronic atlantoaxial rotatory subluxation and congenital absence of the posterior arch of the atlas are rare upper cervical spine abnormalities. The present case is that of a 4-year-old girl who had these two spinal disorders as well as spastic cerebral palsy. The interrelationship, if any, between these three conditions is unclear but presented an unusual diagnostic triad. A posterior spinal fusion between the occiput and third cervical vertebra was performed because of concern for upper cervical spine instability. The patient was immobilized in a halo vest, and a solid fusion occurred within 3 months. Preoperatively the child had never walked independently, but postoperatively, while wearing the halo vest, she was able to walk without external support, thus raising the suspicion of previous spinal instability. Fifteen months postoperatively she remains spastic but has a stable, orthotic-free, independent gait.
创伤后慢性寰枢椎旋转半脱位和先天性寰椎后弓缺如是罕见的上颈椎异常。本病例为一名4岁女孩，患有这两种脊柱疾病以及痉挛性脑瘫。这三种情况之间的相互关系（如果有的话）尚不清楚，但构成了一个不寻常的诊断三联征。由于担心上颈椎不稳定，进行了枕骨至第三颈椎的后路脊柱融合术。患者被固定在头环背心内，3个月内实现了牢固融合。术前该患儿从未独立行走，但术后，在佩戴头环背心时，她能够在无外部支撑的情况下行走，因此引发了对先前脊柱不稳定的怀疑。术后15个月，她仍有痉挛，但步态稳定，无需矫正器，能够独立行走。
