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Traumatic atlanto-axial subluxation.

J D De Beer1, M Thomas, J Walters

  • 1Department of Orthopaedic Surgery, Groote Schuur Hospital, Cape Town, Republic of South Africa.

The Journal of Bone and Joint Surgery. British Volume
|August 1, 1988
PubMed
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Traumatic atlanto-axial subluxation, a rare neck injury, can be missed on X-rays due to muscle spasm. Early surgical consideration is vital to prevent neurological damage in otherwise healthy patients.

Area of Science:

  • Orthopedic Surgery
  • Neurosurgery
  • Radiology

Background:

  • Traumatic atlanto-axial subluxation is a rare but potentially devastating neck injury.
  • Diagnosis can be challenging, often missed on initial radiographic evaluation, particularly with associated muscle spasm.

Observation:

  • Seven patients with traumatic atlanto-axial subluxation following neck injury were analyzed.
  • Only two patients sustained significant head trauma.
  • Three patients developed neurological deficits, with one immediate and two delayed presentations.

Findings:

  • Routine radiography may fail to detect traumatic atlanto-axial subluxation.
  • Neurological deficits can manifest immediately or be delayed.
  • Atlanto-axial instability poses a risk of severe neurological compromise.

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Implications:

  • Early surgical intervention should be strongly considered for traumatic atlanto-axial instability.
  • Prompt diagnosis and treatment are crucial to prevent irreversible neurological damage.
  • This condition requires heightened clinical suspicion in patients with neck injuries, even without significant head trauma.