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CT findings and surgical treatment of atlanto-axial rotatory fixation. A case report

Journal Article:

Abstract

A case of atlanto-axial rotatory fixation (AARF) was presented in a 19-year-old female who developed sudden onset of neck pain and limitation of neck movement after direct carotid angiography for seizure disorder. Neurological examination was negative except for cock-robin posture and mild hypesthesia and hypalgesia in left C/sub 2/ distribution. Plain films of the cervical spine disclosed abnormal alignment of C/sub 1/-C/sub 2/ and possible rotational dislocation. Bilateral selective vertebral angiography showed marked anterior and posterior displacement of left and right vertebral artery, respectively, at the level of C/sub 1/. On CT metrizamide myelography, there was clockwise rotation of C/sub 1/ on C/sub 2/ with locked facet on the left but no evidence of cord compression was found. With diagnosis of AARF, manual reduction under general anesthesia and with fluoroscopic control was first attempted without success. Therefore, the patient underwent open reduction by using high speed air-drill and posterior fusion of C/sub 1/ to C/sub 3/ with acryl and wire. Postoperative course was uneventful and the patient went back to work as a computer operator in three months. The etiology of AARF was described by many authors, but in our case, congenital hypogenesis of transverse and alar ligaments plus minor  More>>
Authors:
Shoji, Akira; Harano, Hideyuki; Okumura, Terufumi; [1]  Nakagawa, Hiroshi; Sugiyama, Tadamitsu
  1. Fukuroi Municipal Hospital, Shizuoka (Japan)
Publication Date:
Jul 01, 1984
Product Type:
Journal Article
Reference Number:
AIX-16-030785; EDB-85-106493
Resource Relation:
Journal Name: Neurol. Surg. (Tokyo); (Japan); Journal Volume: 12:8
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; VERTEBRAE; CAT SCANNING; BONE JOINTS; DIAGNOSIS; IMAGES; MALFORMATIONS; NECK; PATIENTS; BODY; BODY AREAS; COMPUTERIZED TOMOGRAPHY; DIAGNOSTIC TECHNIQUES; ORGANS; PATHOLOGICAL CHANGES; SKELETON; TOMOGRAPHY; 550602* - Medicine- External Radiation in Diagnostics- (1980-)
OSTI ID:
5608524
Country of Origin:
Japan
Language:
Japanese
Other Identifying Numbers:
Journal ID: CODEN: NOKGB
Submitting Site:
HEDB
Size:
Pages: 987-992
Announcement Date:

Journal Article:

Citation Formats

Shoji, Akira, Harano, Hideyuki, Okumura, Terufumi, Nakagawa, Hiroshi, and Sugiyama, Tadamitsu. CT findings and surgical treatment of atlanto-axial rotatory fixation. A case report. Japan: N. p., 1984. Web.
Shoji, Akira, Harano, Hideyuki, Okumura, Terufumi, Nakagawa, Hiroshi, & Sugiyama, Tadamitsu. CT findings and surgical treatment of atlanto-axial rotatory fixation. A case report. Japan.
Shoji, Akira, Harano, Hideyuki, Okumura, Terufumi, Nakagawa, Hiroshi, and Sugiyama, Tadamitsu. 1984. "CT findings and surgical treatment of atlanto-axial rotatory fixation. A case report." Japan.
@misc{etde_5608524,
title = {CT findings and surgical treatment of atlanto-axial rotatory fixation. A case report}
author = {Shoji, Akira, Harano, Hideyuki, Okumura, Terufumi, Nakagawa, Hiroshi, and Sugiyama, Tadamitsu}
abstractNote = {A case of atlanto-axial rotatory fixation (AARF) was presented in a 19-year-old female who developed sudden onset of neck pain and limitation of neck movement after direct carotid angiography for seizure disorder. Neurological examination was negative except for cock-robin posture and mild hypesthesia and hypalgesia in left C/sub 2/ distribution. Plain films of the cervical spine disclosed abnormal alignment of C/sub 1/-C/sub 2/ and possible rotational dislocation. Bilateral selective vertebral angiography showed marked anterior and posterior displacement of left and right vertebral artery, respectively, at the level of C/sub 1/. On CT metrizamide myelography, there was clockwise rotation of C/sub 1/ on C/sub 2/ with locked facet on the left but no evidence of cord compression was found. With diagnosis of AARF, manual reduction under general anesthesia and with fluoroscopic control was first attempted without success. Therefore, the patient underwent open reduction by using high speed air-drill and posterior fusion of C/sub 1/ to C/sub 3/ with acryl and wire. Postoperative course was uneventful and the patient went back to work as a computer operator in three months. The etiology of AARF was described by many authors, but in our case, congenital hypogenesis of transverse and alar ligaments plus minor trauma was most suggested. For neurological manifestations of AARF, occipital neuralgia, headache, neck pain, limitation of neck movement and cock-robin posture were reported, but the cock-robin posture was most characteristic and was an important symptom for the early diagnosis. In neuroradiological findings of AARF, plain CT and CT metrizamide myelography are very useful. Because they clearly demonstrate the degree of rotation and interlocking of atlanto-axial joints, and the presence of cord compression.}
journal = {Neurol. Surg. (Tokyo); (Japan)}
volume = {12:8}
journal type = {AC}
place = {Japan}
year = {1984}
month = {Jul}
}