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Incidental Atlanto Axial Dislocation

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Incidental Findings of the Nervous System

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Abstract

Incidental atlantoaxial dislocation (AAD) is an obscure and abstruse entity. The level of evidence and studies concerning the management strategy of incidental AAD have been rarely published. It demands a thorough evaluation of facet joint alignment and anticipation of progression of the disease to prevent sudden neurological deterioration by acute dislocation. The primary conditions commonly associated with incidental AAD are congenital craniovertebral junction anomalies, rheumatoid arthritis, syndromic AAD, os odontoideum, Chiari malformation, and painless torticollis. The most common pathology among these is congenital AAD. We aim to broadly review the management of incidental AAD while focusing on its diagnosis, management strategies, and various atlantoaxial fixation techniques. Age, disease progression, and degree of instability are the highly essential factors that impact the management strategy. Asymptomatic and fixed variety of AAD can be treated conservatively under strict precaution. All the patients with neurological symptoms or significant neck pain, with radiological confirmation of reducible AAD (overt C1/C2 instability), should undergo surgical stabilization, preferably by the posterior C1/C2 fixation technique. Posterior C1/C2 fusion is still the gold standard for the surgical treatment of incidental AAD.

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Authors and Affiliations

  1. Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India

    Jayesh Sardhara, Ashutosh Kumar, Abhirama Chandra Gabbita & Sanjay Behari

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  1. Jayesh Sardhara
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  2. Ashutosh Kumar
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  3. Abhirama Chandra Gabbita
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  4. Sanjay Behari
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Editor information

Editors and Affiliations

  1. Department of Neurosurgery, Aydın Adnan Menderes University Faculty of Medicine, Aydın, Türkiye

    Mehmet Turgut

  2. Department of Neurosurgery, First Affiliated Hospital of Zhengzhou, Hena, China

    Fuyou Guo

  3. Department of Radiology, Ankara Medipol University Faculty of Medicine, Çankaya, Ankara, Türkiye

    Ahmet Tuncay Turgut

  4. Department of Neurosurgery Sanjay Gandhi, Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

    Sanjay Behari

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Sardhara, J., Kumar, A., Gabbita, A.C., Behari, S. (2023). Incidental Atlanto Axial Dislocation. In: Turgut, M., Guo, F., Turgut, A.T., Behari, S. (eds) Incidental Findings of the Nervous System. Springer, Cham. https://doi.org/10.1007/978-3-031-42595-0_29

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  • DOI: https://doi.org/10.1007/978-3-031-42595-0_29

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