Fielding J W, Hawkins R J
J Bone Joint Surg Am. 1977 Jan;59(1):37-44.
In seventeen cases of irreducible atlanto-axial rotatory subluxation (here called fixation), the striking features were the delay in diagnosis and the persistent clinical and roentgenographic deformities. All patients had torticollis and restricted, often painful neck motion, and seven young patients with long-standing deformity had flattening on one side of the face. The diagnosis was suggested by the plain roentgenograms and tomograms and confirmed by persistence of the deformity as demonstrated by cineroentgenography. Treatment included skull traction, followed by atlanto-axial arthrodesis if necessary. Of the thirteen patients treated by atlanto-axial arthrodesis, eleven had good results, one had a fair result, and one had not been followed for long enough to determine the result. Of the remaining four patients, one treated conservatively had not been followed for long enough to evaluate the result, two declined surgery, and one died while in traction as the result of cord transection produced by further rotation of the atlas on the axis despite the traction.
在17例不可复位的寰枢椎旋转性半脱位（此处称为固定）病例中，显著特点是诊断延迟以及临床和X线畸形持续存在。所有患者均有斜颈，颈部活动受限且常伴有疼痛，7例长期畸形的年轻患者面部一侧扁平。诊断可通过普通X线片和体层摄影提示，并通过动态X线摄影所显示的畸形持续存在得以证实。治疗包括颅骨牵引，必要时行寰枢关节融合术。在接受寰枢关节融合术治疗的13例患者中，11例效果良好，1例效果尚可，1例随访时间不足无法确定效果。其余4例患者中，1例保守治疗因随访时间不足无法评估效果，2例拒绝手术，1例在牵引过程中因寰椎在枢椎上进一步旋转导致脊髓横断而死亡。
