Delayed diagnosis of fractured anterior arch of the atlas in a young child

Sesia, Sergio B.; Prüfer, Friederike; Walther, Michael; Studer, Daniel

doi:10.1136/bcr-2016-214472

Cited by 3 publications

(2 citation statements)

References 37 publications

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“…The common imaging modality of choice for imaging the cervical spine is CT scan due to its sensitivity of around 98% -100% for detecting cervical spine injury [16,20]. By de ining the location and, through three dimensional (3D) reconstruction, the orientation of displaced vertebrae in relation to the spinal canal, CT scans provide a high resolution image of potential cervical spine abnormalities.…”

Section: Imaging Techniquesmentioning

confidence: 99%

“…Furthermore, in a case of a two year old female, a CT scan con irming a fracture of the anterior arch of the atlas was performed after persistent neck pain despite an unremarkable initial radiograph study [19]. Hale, et al compared the quality of radiograph and CT scan for detecting cervical spine injuries from various cases, concluding a 98% sensitivity for CT and only 52% for radiography, where there were no injuries detected on a radiograph that were not also detected on a CT scan [20]. In consideration of the ossi ication process spanning much of childhood, with cervical spine ossi ication not completing until ive to nine years of age, this distinction is likely due to the greater resolution of CT [19].…”

Section: Imaging Techniquesmentioning

confidence: 99%

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Atlantoaxial subluxation in the pediatric patient: Case series and literature review

Mazzola¹,

Christie²,

Snee³

et al. 2020

J Neurosci Neurol Disord

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Objective: Atlantoaxial subluxation (AAS) occurs when there is misalignment of the atlantoaxial joint. Several etiologies confer increased risk of AAS in children, including neck trauma, inflammation, infection, or inherent ligamentous laxity of the cervical spine. Methods: A single-center, retrospective case review was performed. Thirty-four patients with an ICD-10 diagnosis of S13.1 were identified. Demographics and clinical data were reviewed for etiology, imaging techniques, treatment, and clinical outcome. Results: Out of thirty-four patients, twenty-two suffered cervical spine trauma, seven presented with Grisel’s Syndrome, four presented with ligamentous laxity, and one had an unrecognizable etiology. Most diagnoses of cervical spine subluxation and/or instability were detected on computerized tomography (CT), while radiography and magnetic resonance imaging (MRI) were largely performed for follow-up monitoring. Six patients underwent cervical spine fusion, five had halo traction, twelve wore a hard and/or soft collar without having surgery or halo traction, and eight were referred to physical therapy without other interventions. Conclusion: Pediatric patients with atlantoaxial subluxation may benefit from limited 3D CT scans of the upper cervical spine for accurate diagnosis. Conservative treatment with hard cervical collar and immobilization after reduction may be attempted, but halo traction and halo vest immobilization may be necessary. If non-operative treatment fails, cervical spine internal reduction and fixation may be necessary to maintain normal C1-C2 alignment.

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Section: Imaging Techniquesmentioning

confidence: 99%