[Atlanto-axial rotatory fixation. Current diagnosis in torticollis]

Atlantoaxial rotatory fixation is a disorder which must be considered in persistent torticollis. The disorder occurs mainly in children and young adults. The usual etiological factors are traumas or infections of the upper respiratory tract, but the onset may also be spontaneous. The pathogenesis of the fixation is poorly understood. We describe three patients with atlantoaxial rotatory fixation and demonstrate the usefulness of computerized tomography in the diagnosis of this condition. We recommend a posterior atlantoaxial fusion if conservative treatment fails to reduce the rotatory fixation.