Abstract:
STUDY DESIGN:A case report of traumatic atlanto-occipital dislocation managed by transarticular screw fixation. OBJECTIVES:To present a case with initial failed wire fixation but successful reduction and fixation with transarticular screw fixation and occipitocervical plate stabilization. SUMMARY OF BACKGROUND DATA:Atlanto-occipital dislocation is generally a fatal injury, except when it occurs in children. Management of this injury is difficult because of multidirectional instability and the problems associated with technical stabilization. METHODS:Intraoperative atlanto-occipital reduction was achieved and maintained by direct C0-C1 transarticular screw fixation. To protect this fixation, a posterior occipitocervical fusion at C0-C2 using a Y-plate was performed. RESULTS:The internal fixation and reduction were maintained, indicating a good surgical outcome, at examination 2 years after surgery. The initially severe neurologic deficit was reduced to some motor weakness of the right hand and weakness of oculomotor function. CONCLUSIONS:Anatomic reduction and reliable fixation with transarticular screws may provide satisfactory clinical results with important neurologic recovery in cases of atlanto-occipital dislocation.
journal_name
Spine (Phila Pa 1976)journal_title
Spineauthors
Grob Ddoi
10.1097/00007632-200103150-00030keywords:
subject
Has Abstractpub_date
2001-03-15 00:00:00pages
703-7issue
6eissn
0362-2436issn
1528-1159journal_volume
26pub_type
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