Atlantooccipital Dislocation – a Series of Six Patients and Topic Review

Czech version

Authors: V. Beneš III.; P. Barsa; P. Suchomel
Authors‘ workplace: Neurochirurgické oddělení, Krajská nemocnice Liberec, a. s.
Published in: Cesk Slov Neurol N 2013; 76/109(1): 81-85
Category: Short Communication

Overview

Objective:
Atlantooccipital dislocation (AOD) represents highly unstable and usually fatal injury of craniovertebral junction. Improved prehospital emergency care enables AOD sufferers to actually reach a hospital alive. Consequently, we decided to analyse our own series of AOD patients with the aim to highlight the difficulties associated with this injury.

Patients and methods:
We conducted a retrospective analysis of patients admitted during 1993–2010 with the diagnosis of AOD to Regional Hospital Liberec.

Results:
This series included 6 patients (4 women and 2 men, mean age 36.2 years). Upon arrival, all patients were intubated and ventilated. There was no sign of movement on the extremities. All patients had clear radiological findings of AOD. Five patients succumbed to the injury shortly after the diagnosis was established. The sixth patient underwent C0–C2 fusion but died after two months due to ventilator-associated pneumonia and sepsis.

Conclusion:
Our series confirmed high mortality among AOD patients. Spiral CT is the diagnostic test of choice. External orthosis can be used in some selected cases or as a temporary measure. Occipitocervical fusion is the only approach providing immediate and solid stabilization of craniovertebral junction.

Key words:
atlantooccipital dislocation – craniovertebral junction – mortality – spinal cord injury

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

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