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Grisel's syndrome in adults: A case report
Dilyan Ferdinandov1, Dimo Yankov1, Assen Bussarsky1
1Clinic of Neurosurgery, St. Ivan Rilski Hospital, Sofia, Bulgaria.
Surgical Neurology International
|January 27, 2021
Summary
Grisel's syndrome, a rare non-traumatic atlantoaxial rotatory instability, can occur in adults even after successful antibiotic treatment. This case highlights the need for surgical intervention in specific adult cases with developing instability.
Area of Science:
- Spinal Surgery
- Infectious Disease
- Neurology
Background:
- Grisel's syndrome, or non-traumatic, post-inflammatory atlantoaxial rotatory instability, is uncommon in adults.
- Optimal surgical timing and extent for Grisel's syndrome lack consensus, with antibiotic therapy and monitoring as standard care.
Observation:
- A case of C1-C2 spondylitis secondary to retropharyngeal abscess is presented.
- Initial evaluation showed no atlantoaxial instability, but progression to C1-C2 subluxation with myelopathy occurred 3 months post-antibiotics.
Findings:
- Adult Grisel's syndrome can develop secondary instability despite effective antibacterial treatment.
- This case required decompression and delayed surgical fixation.
Implications:
- Highlights the potential for delayed instability in adult Grisel's syndrome.
- Suggests careful monitoring and consideration of surgical intervention in specific adult cases.
- Emphasizes the importance of individualized treatment strategies for rare spinal conditions.
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