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Traumatic occipitoatlantal dislocations

C A Dickman¹, S M Papadopoulos, V K Sonntag

¹Division of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona 85013.

Journal of Spinal Disorders

|August 1, 1993

Summary

This summary is machine-generated.

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Occipitoatlantal dislocations often cause neurological deficits and spinal instability. Urgent surgical fusion is crucial for patients with salvageable function, as nonoperative methods are insufficient for stability.

Area of Science:

Orthopedics
Neurosurgery
Radiology

Background:

Occipitoatlantal dislocations are rare but severe injuries.
These injuries often present with significant neurological deficits and spinal instability.

Observation:

Plain radiographs were diagnostic in most cases (11/14).
Computed tomography (CT) or magnetic resonance (MR) imaging aided diagnosis in three patients.
Rotational subluxations were often radiographically occult.

Findings:

Ten patients died acutely; one died after 3 months from complete C1 quadriplegia.
Three patients with incomplete spinal cord syndromes achieved long-term survival and functional recovery.
Extensive ligamentous injury was a common predisposing factor.

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Implications:

Traction or cervical collars can worsen neurological injury.
Halo immobilization and urgent fusion are essential for patients with salvageable neurological function.
Nonoperative management is inadequate for achieving immediate or long-term spinal stability.