J Korean Neurosurg Soc.  2009 Apr;45(4):246-248. 10.3340/jkns.2009.45.4.246.

Atlantoaxial Rotatory Fixation in Adults Patient

• Jeon SW
• Jeong JH
• Moon SM
• Choi SK

• KMID: 1466299
• DOI: http://doi.org/10.3340/jkns.2009.45.4.246

Abstract

Atlantoaxial rotatory fixation (AARF) in adult is a rare disorder that occurs followed by a trauma. The patients were presented with painful torticollis and a typical 'cock robin' position of the head. The clinical diagnosis is generally difficult and often made in the late stage. In some cases, an irreducible or chronic fixation develops. We reported a case of AARF in adult patient which was treated by immobilization with conservative treatment. A 25-year-old female was presented with a posterior neck pain and limitation of motion of cervical spine after a traffic accident. She had no neurological deficit but suffered from severe defect on the scalp and multiple thoracic compression fractures. Plain radiographs demonstrated torticollis, lateral shift of odontoid process to one side and widening of one side of C1-C2 joint space. Immobilization with a Holter traction were performed and analgesics and muscle relaxants were given. Posterior neck pain and limitation of the cervical spine's motion were resolved. Plain cervical radiographs taken at one month after the injury showed that torticollis disappeared and the dens were in the midline position. The authors reported a case of type I post-traumatic AARF that was successfully treated by immobilization alone.

Keyword

Atlanotaxial subluxation; Adult patient; Radiography; Rotatory fixation; Conservative management; Torticollis

MeSH Terms

Accidents, Traffic
Adult
Analgesics
Female
Fractures, Compression
Head
Humans
Immobilization
Joints
Muscles
Neck Pain
Odontoid Process
Scalp
Spine
Torticollis
Traction
Analgesics