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Related Concept Videos

Articulations of the Vertebral Column01:28

Articulations of the Vertebral Column

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Related Experiment Video

Updated: Jun 16, 2026

Method to Measure Tone of Axial and Proximal Muscle
10:41

Method to Measure Tone of Axial and Proximal Muscle

Published on: December 14, 2011

Atlantoaxial rotatory fixation.

Dachling Pang1

  • 1Department of Pediatric Neurosurgery, University of California, Davis, Regional Center of Pediatric Neurosurgery, Kaiser Foundation Hospitals of Northern California, Oakland, California, USA. PangTV@aol.com

Neurosurgery
|February 23, 2010
PubMed
Summary
This summary is machine-generated.

Atlantoaxial rotatory fixation (AARF) is diagnosed and graded using a 3-position CT motion analysis, establishing a normal template for C1-C2 rotation. Immediate treatment of AARF is crucial to prevent chronic complications and improve outcomes.

Related Experiment Videos

Last Updated: Jun 16, 2026

Method to Measure Tone of Axial and Proximal Muscle
10:41

Method to Measure Tone of Axial and Proximal Muscle

Published on: December 14, 2011

Area of Science:

  • Pediatric Orthopedics
  • Radiology
  • Biomechanical Analysis

Background:

  • Atlantoaxial rotatory fixation (AARF) is a rare condition affecting children.
  • Understanding normal C1-C2 biomechanics is essential for diagnosing AARF.

Purpose of the Study:

  • To establish a normative CT motion analysis of C1-C2 rotation in children.
  • To develop a classification system for AARF based on motion patterns.
  • To correlate AARF types and chronicity with treatment outcomes.

Main Methods:

  • Utilized a 3-position CT protocol to capture C1-C2 motion.
  • Defined three distinct types of AARF (I, II, III) and a diagnostic gray zone (DGZ) based on motion curves.
  • Classified AARF as acute, subacute, or chronic based on treatment delay.
  • Analyzed treatment outcomes, including reduction success, recurrence, and need for fusion.

Main Results:

  • A normative composite motion curve for C1-C2 rotation was established.
  • Treatment difficulty and outcomes significantly worsened with increasing AARF type (I > II > III) and chronicity (chronic > acute).
  • Chronic Type I AARF represented the worst subgroup, while acute Type III represented the best.

Conclusions:

  • The 3-position CT protocol is vital for diagnosing and grading AARF in children with torticollis.
  • Prompt closed reduction with traction is recommended to avoid chronicity.
  • Accurate AARF typing and assessment of treatment delay are critical for selecting appropriate treatment modalities, including C1-C2 fusion for recurrent or irreducible cases.