Surgical Management of Irreducible Atlantoaxial Dislocation

Abstract

The classification and treatment of atlantoaxial dislocations (AAD) remains controversial. Despite existing debate among the literature, it is generally accepted that the treatment of symptomatic AAD should be surgical reduction and fixation. More recently, there has also been acknowledgement among treating surgeons that there are substantial differences between irreducible and reducible AAD, with significant differences between the two groups in terms of the severity of clinical presentation and ideal management [1]. Presently, however, there is little agreement on how best to manage IAAD. Specifically, the importance of anatomical reduction and the method of obtaining proper alignment surgically varies based on the treating surgeon and institution. The purpose of this commentary is to briefly discuss current options for the surgical management of IAAD.