Traumatic occipito-cervical dissociation in adults: a Middle Eastern cohort study

Area of Science:

• Neurosurgery
• Trauma Surgery
• Orthopedic Surgery

Background:

• Cranio-cervical dissociation is a severe injury with significant morbidity and mortality.
• Optimal management strategies remain debated due to rarity and complexity.

Purpose of the Study:

• To describe outcomes of patients with traumatic occipito-cervical dissociation.
• To evaluate surgical management and discuss clinical challenges.
• To review current literature on diagnosis and treatment.

Main Methods:

• Retrospective cohort study of five patients (2010-2016).
• All patients underwent occipito-cervical fusion with screws and rods.
• Mean follow-up of 2.5 years.
• Literature review of diagnostic modalities and treatment outcomes.

Main Results:

• All five patients survived; four achieved independent mobility, one remained wheelchair-bound.
• Neurological sequelae were common, often due to associated injuries.
• Limited neck range of motion was a frequent complaint.
• CT and MRI are key diagnostic tools; surgery is generally indicated.

Conclusions:

• Occipito-cervical fusion can lead to survival and functional recovery in selected patients.
• Missed injuries, head trauma, and significant C1-skull base separation predict mortality.
• Multidisciplinary care is essential for managing these complex injuries.