Traumatic posterior atlantooccipital dislocation with Jefferson and occipital condyle fractures

Chang, Dong‐Gune; Park, Jong-Beom; Cho, Kwang Hyun

doi:10.1097/md.0000000000016668

Cited by 4 publications

(3 citation statements)

References 22 publications

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“…The most common injury mechanism that leads to traumatic posterior AOD and Jefferson fracture is axial loading and compression forces. 12 , 13 The associated lower cervical spine injury was a fracture dislocation of C6-7, which was caused by a compressive flexion injury. Moreover, fracture dislocation at C6-7 was the leading cause of quadriplegia rather than traumatic posterior AOD.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Posterior Atlanto-occipital Dislocation With Three-part Jefferson Fracture and Subaxial Distractive Extension Injury

Chang¹,

Lee²,

Park³

et al. 2021

JAAOS Glob Res Rev

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No previous reports have described combined upper and lower cervical injuries caused by a contrary injury mechanism. A 44-year-old man was transferred complaining of quadriplegia caused by a rear-end collision car accident. CT and MRI findings revealed posterior atlanto-occipital dislocation (AOD) with three-part Jefferson fracture and subaxial distractive extension (DE) injury at the C3-4 and C6-7 levels. MRI showed spinal cord injury at C3-4 and C6-7, which caused quadriplegia and respiratory failure. When the patient arrived at the emergency department, he was already intubated because of respiratory failure. The patient was also hemodynamically unstable after lung injury and pelvic bone fracture. The patient died 1 day after the accident before undergoing surgical intervention. To the best of our knowledge, this is the first report of a case of a traumatic posterior AOD with three-part Jefferson fracture and subaxial DE injury caused by a contrary injury mechanism. Subaxial DE injury, not posterior AOD, caused fatal situation in this case. High index of suspicion and careful radiologic examination are needed to investigate the presence of associated lower cervical spine injury caused by a contrary injury mechanism in traumatic posterior AOD, which may affect treatment, outcome, and prognosis.

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Section: Discussionmentioning

confidence: 99%

Traumatic Posterior Atlanto-occipital Dislocation With Three-part Jefferson Fracture and Subaxial Distractive Extension Injury

Chang¹,

Lee²,

Park³

et al. 2021

JAAOS Glob Res Rev

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“…Furthermore, the report on survival in traumatic AOD is extremely rare and only showed in the form of a case report. 3 4 5 6 7 Early surgical stabilization including OCF is recommended as the standard treatment. In the case of intractable neck pain by severe osteoarthritis of atlanto-occipital or antlato-axial joint, the neck pain could be significantly improved by OCF or atlanto-axial fusion.…”

Section: Discussionmentioning

confidence: 99%

“… 1 , 2 Therefore, traumatic AOD is often reported in the form of a case report. 3 4 5 6 7 Diagnosis of traumatic AOD was usually neglected because of low clinical suspicion, severe polytrauma, and difficult to radiographic evaluation of the craniovertebral junction. 8 - 10…”

mentioning

confidence: 99%

Cervical Myelopathy Caused by Posttraumatic Osteophytes Resulting From Long-Standing Neglected Posterior Atlanto-Occipital Dislocation More Than 30 years: A Case Report

Chang¹,

Park²,

Park³

et al. 2021

JAAOS Glob Res Rev

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Introduction: Traumatic atlanto-occipital dislocation (AOD) is a rare but usually fatal injury. To our knowledge, no study has reported long-standing neglected posterior AOD more than 30 years in a patient who survived and later experienced cervical myelopathy. Methods: A 75-year-old man presented with symptoms of cervical myelopathy. On history, the patient was diagnosed with posterior AOD that occurred after a fall 31 years ago, but he did not undergo surgery. Radiologic evaluation of cervical spine revealed severe spinal cord compression caused by posttraumatic osteophytes of the C0-C1-C2 joints resulting from long-standing neglected posterior AOD. However, no instability of the C0-C1-C2 joints was found. Results: Laminectomy of the C1 posterior arch was performed without occipitocervical fusion considering the long-standing severe osteoarthritic changes and no instability of the C0-C1-C2 joints. Cervical myelopathy significantly improved, and the patient was doing well without recurrence at the 7-year follow-up. Discussion: To our knowledge, this is the first report of a patient with cervical myelopathy caused by neglected posterior AOD with posttraumatic osteophytes of the C0-C1-C2 joints. Laminectomy of the C1 posterior arch without occipitocervical fusion achieved satisfactory outcomes for cervical myelopathy caused by posttraumatic osteophytes resulting from long-standing neglected posterior AOD more than 30 years.

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Clinical Diagnosis and Treatment of 43 Cases of Occipital Condylar Fractures: A Single-Center Retrospective Study

Zhang,

Meng

et al. 2024

World Neurosurgery

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Traumatic posterior atlantooccipital dislocation with Jefferson and occipital condyle fractures

Cited by 4 publications

References 22 publications

Traumatic Posterior Atlanto-occipital Dislocation With Three-part Jefferson Fracture and Subaxial Distractive Extension Injury

Traumatic Posterior Atlanto-occipital Dislocation With Three-part Jefferson Fracture and Subaxial Distractive Extension Injury

Cervical Myelopathy Caused by Posttraumatic Osteophytes Resulting From Long-Standing Neglected Posterior Atlanto-Occipital Dislocation More Than 30 years: A Case Report

Clinical Diagnosis and Treatment of 43 Cases of Occipital Condylar Fractures: A Single-Center Retrospective Study

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