Author/Authors :
Eghbal, Keyvan Department of Neurosurgery - Shiraz University of Medical Sciences, Shiraz , Rakhsha, Abbas Department of Neurosurgery - Shiraz University of Medical Sciences, Shiraz , Saffarrian, Arash Department of Neurosurgery - Shiraz University of Medical Sciences, Shiraz , Rahmanian, Abdolkarim Department of Neurosurgery - Shiraz University of Medical Sciences, Shiraz , Abdollahpour, Hamid Reza Department of Orthopedics - Shiraz University of Medical Sciences, Shiraz , Ghaffarpasand, Fariborz Resident of Neurosurger - Student Research Committee - Department of Neurosurgery - Shiraz University of Medical Sciences, Shiraz
Abstract :
Atlantoaxial rotatory subluxation (AARS) is rarely occurred in adults with trauma as the most common cause. In type A and B it is usually managed with close reduction and external brace; however, in nonresponsive cases, surgical interventions might be needed. Our patient is a 21-year-old man with neck pain and torticollis after a car turn- over. There was C1-C2 rotatory subluxation with left side locked facet and C1 rotation about 40 degrees relative to C2 on computed tomography without evident of ligamentous injury in magnetic resonance imaging (MRI). However, during the first 48 hours, two tries of close reduction using Gardner cervical traction under fluoroscopy were failed. Thus, the patient underwent open reduction of the subluxation and atlantoaxial fixation (Harm’s technique) with subsequent relief of pain and torticollis. This a rare case of traumatic AARS type A with unilateral locked facet joint in an adult patient which needed surgical manipulation for reduction. The management of the AARS in adults should be individualized in each patient.
Keywords :
Atlantoaxial rotatory subluxation (AARS) , Atlantoaxial fixation , Trauma , Adult
