Atlantoaxial subluxation in an adult secondary to retropharyngeal abscess

Morita, Takeshi; Fujiki, Nobuya; Shiomi, Yosaku; Kurata, Kyosuke; Oda, Naoharu

doi:10.1016/s0385-8146(00)00101-2

Cited by 7 publications

(8 citation statements)

References 2 publications

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“…Only 2 adult cases have been reported in the literature. 7 Nontraumatic atlantoaxial subluxation in an adult due to RPA has been only sporadically reported, and one case study unlike this one was treated nonsurgically. 6 Another case study discussed severe atlantoaxial subluxation in an adult secondary to RPA.…”

Section: Discussionmentioning

confidence: 89%

“…1,[5][6][7][8][9][10] Retropharyngeal abscess is a potentially serious deep neck space infection and can be of medical or traumatic origin. 9 The incidence of these infections has dropped because of the advent of antibiotics.…”

Section: Discussionmentioning

confidence: 99%

“…External fixation with a collar was tried initially; eventually, surgical fusion was performed for the remaining instability. 7 Diagnosis of RPA is based on clinical suspicion with supportive imaging studies. Deep neck spaces are created by various fasciae of the head and neck, and are potential spaces that cannot be examined clinically.…”

Section: Discussionmentioning

confidence: 99%

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Retropharyngeal Abscess Presenting as Benign Neck Pain

Fogeltanz

Pursel

2006

Journal of Manipulative and Physiological Therapeutics

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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Retropharyngeal Abscess Presenting as Benign Neck Pain

Fogeltanz

Pursel

2006

Journal of Manipulative and Physiological Therapeutics

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“…Several previous studies have reported that for patients with an infection that cannot be controlled with aggressive intravenous antibiotics treatment or for those with neurological deficits who cannot be stabilized by external fixation, curettage or decompression should be performed [ 3 , 5 , 6 , 8 , 12 , 13 ]. In our case, the infection status and motor deficits both improved after the initial administration of antibiotics and halo vest fixation, and surgical intervention was not required.…”

Section: Discussionmentioning

confidence: 99%

“…Due to the quite rare manifestation of AAS after pyogenic spondylitis, there is still an argument for surgical intervention for AAS secondary to the pyogenic infection. Morita et al described that if instability of the atlantoaxial joint persists, surgical management should be considered [ 3 ]. On the other hand, Spies et al reported a case that demonstrated destruction of the atlantoaxial and atlantooccipital joints on one side, and surgical intervention was not necessary [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Atlantoaxial Subluxation after Pyogenic Spondylitis around the Odontoid Process

Hasegawa

Yagi

Takemitsu

et al. 2015

Case Reports in Orthopedics

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Study Design. A case report and review of the literature. Objective. The aim of this study was to describe the conservative management of pyogenic spondylitis around the odontoid process. Summary of Background Data. Atlantoaxial subluxation after pyogenic spondylitis is rare. The therapeutic approach to infection of the upper cervical spine is controversial. Methods. Medical chart and radiological images of a 76-year-old male patient were retrospectively reviewed. Radiography revealed atlantoaxial subluxation, and an abscess was seen around the odontoid process on magnetic resonance images. Intravenous antibiotics and a halo vest were used to treat the patient. We then observed the patient's conservative treatment course. Results. C-reactive protein levels returned to normal 4 weeks after administration of the intravenous antibiotics. The patient's muscle weakness also completely recovered 8 weeks after administration of the intravenous antibiotics. Because the patient was able to walk without any support, surgical treatment was not necessary. Conclusions. Pyogenic spondylitis of the upper cervical spine is a rare manifestation. Surgical or conservative treatment must be selected carefully based on the patient's symptoms. If early diagnosis and treatment can be provided to the patients, conservative treatment can be achieved.

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