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Challenges in Occipitocervical Fusion in a 9-Month-Old Infant: A Case Report and Review of Literature.
Neurol India
January 2024
Spine Care Centre, Manipal Hospital HAL Old Airport Road, Bengaluru, Karnataka, India.
Traumatic cranio-cervical junction injuries in infants are rare and require early surgical stabilization. In view of the unique anatomy of the occipitocervical junction in infants, the creation of a fusion construct that is both safe and biomechanically sound is challenging. A 9-month-old male infant involved in an accident presented with weakness in both upper limbs.
View Article and Find Full Text PDFSuccessful non-operative treatment of traumatic atlanto-occipital dislocation: a case report.
J Spine Surg
December 2023
Department of Orthopedic Surgery and Rehabilitation, University of Nebraska Medical Center, Omaha, NE, USA.
Background: Traumatic atlanto-occipital dislocation (AOD) is most commonly treated with cranio-cervical fusion. We present a unique case in which a partial neurological recovery was made after non-operative treatment was done for AOD. Reports of non-operative treatment of this condition are rare in the literature.
View Article and Find Full Text PDFA Novel Treatment of Pediatric Atlanto-Occipital Dislocation with Nonfusion Using Muscle-Preserving Temporary Internal Fixation of C0-C2: Case Series and Technical Note.
J Neurol Surg Rep
January 2023
Department of Surgical Sciences, Uppsala University Hospital, Uppsala University, Uppsala, Sweden.
Case series with surgical technical note. This article reports experiences and results of muscle-preserving temporary C0-C2 fixation for the treatment of atlanto-occipital dislocation (AOD). AOD is a rare injury caused by high-energy trauma, occurring in less than 1% of pediatric trauma patients.
View Article and Find Full Text PDFInterrelationship Between Craniocervical Dissociation Spectrum Injuries and Atlantoaxial Instability on Trauma Cervical MRI Examinations.
Cureus
November 2022
Neuroradiology, University of Florida College of Medicine, Jacksonville, USA.
Background and purpose Craniocervical dissociation injuries encompass a spectrum of osteoligamentous injuries between the skull base and C1-C2 that may be treated via prolonged external immobilization versus occipital cervical fusion depending on the risk of persistent craniocervical instability. However, the presence of atlantoaxial instability (AAI) at C1-C2, as determined by transverse atlantal ligament (TAL) integrity with or without a C1 fracture, may guide the neurosurgical management of craniocervical dissociation spectrum injuries (CDSI) since it implies an overall greater degree of instability at the craniocervical junction (CCJ). Materials and methods Adult trauma patients who suffered a transverse atlantal ligament injury on cervical magnetic resonance imaging (MRI) were identified retrospectively.
View Article and Find Full Text PDFManagement of Traumatic Atlantooccipital Dissociation at a Level 1 Trauma Center: A Retrospective Case Series.
World Neurosurg
February 2023
Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Objective: Atlantooccipital dislocation (AOD) is a highly unstable and often neurologically devastating injury to the craniocervical junction that typically results from high-energy trauma. Management of these devastating injuries is complex, with prognostication difficult due to high rates of concomitant intracranial and systemic injuries. This report highlights advances in management of AOD and appropriate implementation of operative adjuncts including neuronavigation and the use of intraoperative neuromonitoring.
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