Moore K R, Frank E H
Division of Neurosurgery, Oregon Health Sciences University, Portland, USA.
Spine (Phila Pa 1976). 1995 Sep 1;20(17):1928-30. doi: 10.1097/00007632-199509000-00016.
This is a retrospective single-patient case report with a literature review.
To report on a neurologically intact adult with bilateral traumatic atlantoaxial rotatory subluxation/dislocation and associated facet fracture, and present a review of the literature.
Unilateral rotatory dislocation is relatively common at the atlantoaxial articulation. On the contrary, atlantoaxial rotatory subluxation with bilateral facet dislocation is uncommon, particularly in adults. Periodic reports have appeared in the literature regarding this entity in children, but only two previous citations have involved adults.
The patient was followed-up through personal examination and chart review from initial presentation to 5 months after discharge.
Closed reduction with cervical traction was followed by surgical fusion with stable repair and no neurologic deficits over 5 months follow-up.
Traumatic bilateral atlantoaxial rotatory subluxation is uncommon in adults. This probably is due to the unique biomechanical features of the atlantoaxial articulation and the probable lethality of injury to the adjacent medulla or vertebral arteries before presentation at the trauma center.
这是一篇带有文献综述的回顾性单病例报告。
报告一例神经系统完整的成年患者，其患有双侧创伤性寰枢椎旋转半脱位/脱位及相关关节突骨折，并对文献进行综述。
单侧旋转脱位在寰枢关节相对常见。相反，双侧关节突脱位的寰枢椎旋转半脱位并不常见，尤其是在成年人中。文献中定期会出现关于儿童该病症的报道，但此前仅有两篇涉及成年人的文献引用。
对患者进行随访，从初次就诊到出院后5个月，通过体格检查和病历回顾。
采用颈椎牵引进行闭合复位，随后进行手术融合，修复稳定，在5个月的随访中无神经功能缺损。
创伤性双侧寰枢椎旋转半脱位在成年人中并不常见。这可能是由于寰枢关节独特的生物力学特征，以及在创伤中心就诊前，相邻延髓或椎动脉损伤可能导致的致死性。
