Journal of Craniovertebral Junction and Spine

CASE REPORT
Year
: 2016  |  Volume : 7  |  Issue : 4  |  Page : 273--275

Accessory atlantoaxial ligament avulsion fracture of the axis: Are there any clinical implications?


Hamid Reza Niknejad1, Frank van Calenbergh1, Philippe Demaerel2, Johannes van Loon1 
1 Department of Neurosurgery, University Hospitals Leuven, Herestraat 49, Leuven 3000, Belgium
2 Department of Neuroradiology, University Hospitals Leuven, Herestraat 49, Leuven 3000, Belgium

Correspondence Address:
Hamid Reza Niknejad
Department of Neurosurgery, University Hospitals Leuven, Herestraat 49, Leuven 3000
Belgium

Injuries to the craniocervical support structures are frequently observed in neurotrauma cases. Stability of this region is of vital importance. Literature has mainly focused on three major ligaments of the craniocervical junction: The tectorial membrane, the transverse ligament, and the alar ligaments. However, the accessory atlantoaxial ligament (ALL) also seems to be involved in craniocervical stability as shown in cadaveric specimens. Still, the biomechanical importance of this structure needs to be determined, especially in trauma settings. Here, we describe a case of isolated traumatic injury to this structure and discuss the clinical outcome. A 64 year old polytrauma patient with a remarkable avulsion fracture at the site of the insertion of the ALL was admitted to our center. We evaluated the patient both clinical and radiological at admission, after 3 months and after 1 year. We clinically assessed the upper cervical rotational stability using the cervical flexion rotation test. We observed no rotational instability or any other clinical repercussions at the long term after an isolated ALL injury. This case shows that isolated traumatic damage to the ALL is possible. Unilateral damage to the ALL probably does not cause rotational instability of the craniocervical junction. In case a similar avulsion fracture is observed, we recommend performing a magnetic resonance imaging of the craniovertebral region to assess for any ligamentous lesions.


How to cite this article:
Niknejad HR, van Calenbergh F, Demaerel P, van Loon J. Accessory atlantoaxial ligament avulsion fracture of the axis: Are there any clinical implications?.J Craniovert Jun Spine 2016;7:273-275


How to cite this URL:
Niknejad HR, van Calenbergh F, Demaerel P, van Loon J. Accessory atlantoaxial ligament avulsion fracture of the axis: Are there any clinical implications?. J Craniovert Jun Spine [serial online] 2016 [cited 2022 Jan 28 ];7:273-275
Available from: https://www.jcvjs.com/article.asp?issn=0974-8237;year=2016;volume=7;issue=4;spage=273;epage=275;aulast=Niknejad;type=0