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Evaluation of traumatic atlantooccipital dislocations
AJNR. American Journal of Neuroradiology
|January 1, 1987
Summary
Diagnosing traumatic atlantooccipital dislocation (AOD) is challenging with standard X-rays. A new X-line method shows promise for improved diagnosis of AOD, though CT scans remain definitive.
Area of Science:
- Radiology
- Orthopedic Surgery
- Trauma Imaging
Background:
- Diagnosing traumatic atlantooccipital dislocation (AOD) is difficult due to complex anatomy and intricate radiographic techniques.
- Lateral radiographs are often used for AOD diagnosis despite limitations.
Purpose of the Study:
- To evaluate the best plain radiographic methods for diagnosing AOD.
- To determine the role of CT and polytomography in AOD diagnosis.
Main Methods:
- Literature review on AOD diagnostic methods.
- Application of Wholey dens-basion line, Powers ratio, Dublin method, and atlantooccipital joint width measurement to 12 traumatic AOD cases.
- Development and testing of the novel X-line method for AOD diagnosis.
- Assessment of Wholey dens-basion line and Powers ratio in 150 normal individuals.
Main Results:
- The novel X-line method achieved 75% accuracy in diagnosing AOD.
- Wholey dens-basion line and atlantooccipital joint width measurement had 50% accuracy.
- Powers ratio and Dublin method showed lower accuracy (33% and 25%, respectively).
Conclusions:
- The X-line method offers improved accuracy for diagnosing AOD on plain radiographs.
- High-resolution CT with reformatted images is recommended as the primary advanced imaging modality for definitive AOD diagnosis.