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Nonsurgical Management of Combined Occipitocervical and Atlantoaxial Distraction Injuries: A Case Report
Joshua M Kolz1, Tyson C Christensen1, Felix E Diehn2
1Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota.
Case:
A 41-year-old man sustained occipitocervical dislocation (OCD) and atlantoaxial dislocation (AAD) injuries in a motor vehicle collision. These injuries were treated nonoperatively with a hard cervical collar and activity restrictions with an excellent result at 4-year follow-up.
Conclusion:
OCD and AAD injuries require prompt diagnosis and immobilization. Standard of care for coexisting injuries is occipitocervical fusion; however, some patients have coexisting injuries which may prevent operative treatment. These polytrauma patients require a creative nonoperative approach with close follow-up to avoid neurologic decline.
