Filipe G, Berges O, Lebard J P, Carlioz H
Rev Chir Orthop Reparatrice Appar Mot. 1982;68(7):461-9.
The authors have observed 5 cases of atlanto-axial instability in children aged from 18 months to 8 years. All the cases were seen after severe trauma and presented with abnormal neurological signs. All patients were first treated conservatively and were operated on secondarily by atlanto-axial fusion using graft and wiring for persistent radiological instability between the atlas and axis. In two cases instability was due to an atlanto-axial subluxation with rupture of the transverse ligament; one of these was reduced by traction. In one case there was an anterior subluxation without fracture. In one case there was a fracture of the odontoid process in which instability persisted in spite of bony union of the fracture. In the last case, the odontoid process was intact shortly after the trauma but its central portion disappeared secondarily. The cause of this disappearance is discussed.
作者观察了5例年龄在18个月至8岁之间的儿童寰枢椎不稳病例。所有病例均在严重创伤后出现，伴有异常神经体征。所有患者均首先接受保守治疗，对于寰椎和枢椎之间持续存在放射学不稳定的情况，二期行寰枢椎融合术，采用植骨和钢丝固定。2例不稳是由于寰枢椎半脱位伴横韧带断裂，其中1例经牵引复位。1例为无骨折的前脱位。1例为齿突骨折，尽管骨折已骨性愈合，但仍存在不稳。在最后1例中，创伤后齿突短期内完整，但随后其中心部分消失，文中讨论了这种消失的原因。
