Journal of Craniovertebral Junction and Spine

CASE REPORT
Year
: 2013  |  Volume : 4  |  Issue : 2  |  Page : 90--93

Unique paradoxical atlantoaxial dislocation with C1-C2 facet diastases and isolated ligamentous injury to the craniovertebral junction without neurological deficits: A case report


Aniruddha Thekkatte Jagannatha1, Umesh Srikantha1, Papa Raja Murthy2, Ravi Gopal Varma1, Hariprakash Chakravarthy1, Alangar Sathya Hegde3 
1 Department of Neurosurgery, M S Ramaiah Institute of Neurosciences, M S Ramaiah Medical College, Bangalore, India
2 Department of Neurosurgery, R L Jalappa Medical college, Tamaka, Kolar, Karnataka, India
3 Senior Professor and Director, M S Ramaiah Institute of Neurosciences, M S Ramaiah Medical College, Bangalore, India

Correspondence Address:
Aniruddha Thekkatte Jagannatha
Department of Neurosurgery, M S Ramaiah Institute of Neurosciences, M S Ramaiah Medical College, New BEL Road-54, Bangalore, Karnataka
India

Study design: Retrospective review of the case file. Objective: The primary objective was to report this rare case and discuss the mechanism of dislocation and technique of manual closed reduction of C1-C2 vertebrae in such scenarios. Summary of background data: Posterior atlantoaxial dislocation (AAD) is extremely rare and a few cases have been reported in English literature. This young man sustained a high speed car accident and survived an extreme hyperextension injury to the craniovertebral junction (CVJ) without any neurological deficits. On evaluation for neck pain he was noted with a dislocated odontoid lying in front of Atlas. There was C1-C2 facet diastases. No bony injury was noted at CVJ. Transverse axial ligament (TAL) was intact. He underwent a successful awake reduction of the dislocation. The joint had to be manually distracted, realigned, and released under the guidance of fluoroscopy. This was followed by single stage C1-C2 Goel«SQ»s fusion with awake prone positioning. This patient was able to go back to work at the end of 3 months (GOS 5). Conclusions: This condition is extremely rare, can be carefully reduced manually under adequate neuromonitoring, and requires C1-C2 fusion in the same sitting.


How to cite this article:
Jagannatha AT, Srikantha U, Murthy PR, Varma RG, Chakravarthy H, Hegde AS. Unique paradoxical atlantoaxial dislocation with C1-C2 facet diastases and isolated ligamentous injury to the craniovertebral junction without neurological deficits: A case report.J Craniovert Jun Spine 2013;4:90-93


How to cite this URL:
Jagannatha AT, Srikantha U, Murthy PR, Varma RG, Chakravarthy H, Hegde AS. Unique paradoxical atlantoaxial dislocation with C1-C2 facet diastases and isolated ligamentous injury to the craniovertebral junction without neurological deficits: A case report. J Craniovert Jun Spine [serial online] 2013 [cited 2020 Aug 4 ];4:90-93
Available from: http://www.jcvjs.com/article.asp?issn=0974-8237;year=2013;volume=4;issue=2;spage=90;epage=93;aulast=Jagannatha;type=0