Skip to main content

Advertisement

Log in

Nontraumatic posterior atlantooccipital dislocation associated with atlantoaxial instability

  • Case Report
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Introduction

Nontraumatic posterior atlantooccipital dislocation has only been rarely reported. In the current study, the authors reported an extremely rare case of nontraumatic posterior atlantooccipital dislocation associated with atlantoaxial instability.

Materials and methods

A 47-year-old female was referred with a history of neck pain for 5 years. The patient had no history of trauma. The axial rotation of range of motion of the cervical spine was severely restricted. Posterior atlantooccipital dislocation with atlantoaxial instability was confirmed through conventional radiography, computed tomography and magnetic resonance imaging. We performed realignment of the dislocation and posterior occipitocervical (C0–C2) fusion. After the surgery, the patient’s symptoms improved significantly and she manifested neurological improvement.

Conclusion

To our knowledge, this lesion has not been reported previously. Anomalies of upper cervical spine may have induced this instability.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Hungerford GD, Akkaraju V, Rawe SE (1981) Atlanto-occipital and atlantoaxial dislocation with spinal cord compression in Down’s syndrome: a case report and review of the literature. Br J Radiol 54:758–761

    Article  CAS  PubMed  Google Scholar 

  2. Granthan SA, Lipson SJ (1989) Rheumatoid arthritis of the cervical spine. In: The Cervical Spine Research Society (eds) The cervical spine. Lippincott, Philadelphia, pp 564–572

  3. Verbiest H (1989) Benign cervical spine tumors: clinical experience. In: The Cervical Spine Research Society (eds) The cervical spine. Lippincott, Philadelphia, pp 723–791

  4. Washington ER (1959) Non-traumatic atlanto-occipital and atlanto-axial dislocation: a case report. J Bone Jt Surg Am 41-A:341–344

    CAS  Google Scholar 

  5. Hettiaratchy S, Ning C, Sabin I (1998) Nontraumatic atlanto-occipital and atlantoaxial rotatory subluxation: case report. Neurosurgery 43:162–164 (discussion 164–5)

    Article  CAS  PubMed  Google Scholar 

  6. Wang C, Yin SM, Yan M, Zhou HT, Dang GT (2004) Posterior occipitocervical fixation using C2 pedicle screws and occipitocervical plate systems. Zhonghua Wai Ke Za Zhi 42:707–711

    PubMed  Google Scholar 

  7. Guigui P, Milaire M, Morvan G, Lassale B, Deburge A (1995) Traumatic atlantooccipital dislocation with survival: case report and review of the literature. Eur Spine J 4:242–247

    Article  CAS  PubMed  Google Scholar 

  8. Hosalkar HS, Cain EL, Horn D, Chin KR, Dormans JP, Drummond DS (2005) Traumatic atlanto-occipital dislocation in children. J Bone Jt Surg Am 87:2480–2488

    Article  Google Scholar 

  9. Abumi K, Fujiya M, Saita N, Kaneda K (1998) Occipitoatlantal instability associated with articular tropism. Eur Spine J 7:76–79

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  10. Takechi Y, Iizuka H, Sorimachi Y, Ara T, Nishinome M, Takagishi K (2011) Non-traumatic posterior atlanto-occipital joint dislocation. Eur Spine J 20:S172–S175

    Article  PubMed  Google Scholar 

  11. Wiesel SW, Rothman RH (1979) Occipitoatlantal hypermobility. Spine 4:187–191

    Article  CAS  PubMed  Google Scholar 

  12. Georgopoulos G, Pizzutillo PD, Lee MS (1987) Occipito-atlantal instability in children. A report of five cases and review of the literature. J Bone Jt Surg Am 69:429–436

    CAS  Google Scholar 

  13. Stulík J, Klézl Z, Sebesta P, Kryl J, Vyskocil T (2009) Occipitocervical fixation: long term follow-up in fifty-seven patients. Acta Chir Orthop Traumatol Cech 76:479–486

    PubMed  Google Scholar 

  14. Ogihara N, Takahashi J, Hirabayashi H, Hashidate H, Mukaiyama K, Kato H (2012) Stable reconstruction using halo vest for unstable upper cervical spine and occipitocervical instability. Eur Spine J 21:295–303

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Conflict of interest

None of the authors has any potential conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Xi-Gao Cheng.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wu, TL., Jia, JY., Chen, WC. et al. Nontraumatic posterior atlantooccipital dislocation associated with atlantoaxial instability. Eur Spine J 24 (Suppl 4), 619–622 (2015). https://doi.org/10.1007/s00586-015-3901-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-015-3901-6

Keywords

Navigation