Abstract
This report presents a case of non-traumatic posterior atlanto-occipital dislocation. A 36-year-old female was referred with a history of numbness of the extremities, vertigo and neck pain for 1 year. The patient had no history of trauma. The axial rotation of range of motion of the cervical spine was severely restricted. A lateral cervical radiograph in the neutral position demonstrated a posterior atlanto-occipital dislocation. A coronal view on a computed tomography (CT) reconstruction image showed a loss of angle of the bilateral atlanto-occipital joint, and a sagittal reconstruction view of CT images also demonstrated flatness of atlanto-occipital joint. Instrumented occipito-cervical fusion was performed after reduction. A lateral cervical radiograph in the neutral position 1 year after surgery showed the reduction of atlanto-occipital joint, moreover, it was maintained even in an extended position. The patient had neurologic improvement after surgery. Flatness of the bilateral atlanto-occipital joint may have induced this instability. Occipital–cervical fusion was chosen in the present case since the patient showed restricted axial rotation of the neck before surgery. The surgery improved the preoperative symptoms including the function of cervical spine evaluated by JOACMEQ.
References
Abumi K, Fujiya M, Saita N, Kaneda K (1998) Occipitoatlantal instability associated with articular tropism. Eur Spine J 7:76–79
Fukui M, Chiba K, Kawakami M et al (2007) An outcome measure for patients with cervical myelopathy: Japanese Orthopaedic Association Cervical Myelopathy Questionnare (JOACMEQ): part 1. J Orthop Sci 12:227–240
Grob D (2001) Transarticular screw fixation for atlanto-occipital dislocation. Spine 26:703–707
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
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
McRae DL (1953) Bony abnormalities in the region of the foramen magnum: correlation of the anatomic and neurologic findings. Acta Radiol 40:335–354
Papadopoulos SM, Dickman CA, Sonntag VK, Rekate HL, Spetzier RF (1991) Traumatic atlantooccipital dislocation with survival. Neurosurgery 28:574–579
Conflict of interest statement
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Takechi, Y., Iizuka, H., Sorimachi, Y. et al. Non-traumatic posterior atlanto-occipital joint dislocation. Eur Spine J 20 (Suppl 2), 172–175 (2011). https://doi.org/10.1007/s00586-010-1480-0
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00586-010-1480-0