J Korean Soc Radiol.  2017 Mar;76(3):233-236. 10.3348/jksr.2017.76.3.233.

Traumatic Posterior Atlantoaxial Dislocation without Fracture of the Odontoid Process: A Case Report and Literature Review

• Kim YK
• Park JG
• Jung HN
• Kim JW
• Lee SJ

• KMID: 2371692
• DOI: http://doi.org/10.3348/jksr.2017.76.3.233

Abstract

Traumatic posterior atlantoaxial dislocation without odontoid fracture is very rare. Patient prognosis depends on the neurologic symptoms or the extent of damage to the structures. In this case, a 78-year-old-male suffered a posterior atlantoaxial dislocation without odontoid fracture after a traffic accident. We report this case because an exact diagnosis and proper treatment can reduce the neurologic complications in patients with posterior atlantoaxial dislocation.

MeSH Terms

Accidents, Traffic
Diagnosis
Dislocations*
Humans
Multimodal Imaging
Neurologic Manifestations
Odontoid Process*
Prognosis

Figure

• 

  Fig. 1. Traumatic posterior atlantoaxial dislocation without fracture of the odontoid process in a 78-year-old man. Cervical spine lateral radiography (A) shows posterior dislocation of the atlas with respect to the axis. Axial computed tomography (CT) scan (B) shows that the odontoid process is located anterior to the atlas. Sagittal CT image (C) demonstrates no evidence of odontoid fracture. T2-weighted sagittal magnetic resonance (MR) (D) and fat suppression T2-weighted sagittal MR (E) demonstrate ruptured anterior longitudinal and posterior longitudinal ligaments (arrows). Also, the apical ligament (black arrowhead) is detached from the odontoid process. T2-weighted sagit-tal (D) and coronal MR (F) images show an intact transverse ligament (white arrowheads). Fluid collection or hematoma is noted in the upper cervical prevertebral and epidural regions (asterisks on image D, E and G). There is no spinal cord signal abnormality.

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