Abumi K, Fujiya M, Saita M, Kaneda K
Department of Orthopaedic Surgery, Hokkaido University School of Medicine, Sapporo, Japan.
Eur Spine J. 1998;7(1):76-9. doi: 10.1007/s005860050033.
The authors report the case of a patient with rotatory posterior subluxation of the occiput on the atlas associated with tropism of the O-C1 articulations. Lateral flexion-extension plain films demonstrated 5 mm of posterior translation of the occiput on the atlas. Tomographs revealed tropism of the O-C1 articulations, and CT scans on extension demonstrated posterior rotatory subluxation of the occiput on the atlas. The patient had no osseous abnormality caudally below the atlantoaxial joint, and underwent posterior occipitoatlantal fusion by wiring. At the 4-year follow-up, the grafted bone had been incorporated, and the patient was completely free from preoperative symptoms. In the present patient, occipitoatlantal instability is presumed to have derived from articular tropism.
作者报告了一例枕骨相对于寰椎发生旋转性后脱位并伴有枕-寰关节不对称的患者。颈椎侧位屈伸位平片显示枕骨相对于寰椎向后移位5mm。断层扫描显示枕-寰关节不对称，伸展位CT扫描显示枕骨相对于寰椎发生后旋转半脱位。患者在寰枢椎关节下方没有骨质异常，接受了后路枕颈融合术。在4年的随访中，移植骨已融合，患者术前症状完全消失。在本病例中，枕颈不稳定被推测源于关节不对称。
