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Spontaneous atlantoaxial subluxation associated with tonsillitis
Meenalochani Shunmugam1, Santosh Poonnoose1
1Department of Neurosurgery, Flinders Medical Centre, Flinders Drive, Bedford Park, Adelaide, SA 5042, Australia.
Asian Journal of Neurosurgery
|May 15, 2015
Summary
Late presentation of atlantoaxial rotatory subluxation in a teen required invasive management. This case highlights the importance of timely diagnosis and treatment for this rare condition to prevent long-term issues.
Area of Science:
- Orthopedics
- Neurology
- Radiology
Background:
- Atlantoaxial subluxation is a rare condition often requiring a high index of suspicion for diagnosis and treatment.
- Prompt management is crucial to prevent long-term sequelae.
Observation:
- A 17-year-old female presented with late-onset, nontraumatic rotatory atlantoaxial subluxation.
- Symptoms included nonspecific upper limb sensory disturbances that resolved spontaneously.
- Computed tomography revealed a Type 1 dislocation with rotatory fixation and minimal anterior atlas displacement.
Findings:
- Conservative management was ineffective.
- Due to late presentation and fixed deformity, invasive treatment was necessary.
- Gardner-Wells tongs with traction, followed by a HALO brace, were used for reduction and immobilization.
Implications:
- This case underscores the need for vigilance in diagnosing rare spinal conditions.
- Effective management, even in late presentations, can lead to satisfactory outcomes.
- Advanced immobilization techniques may be required for complex atlantoaxial rotatory subluxation.
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