Successful non-operative treatment of traumatic atlanto-occipital dislocation: a case report.

Autor:	Gertz K; Department of Orthopedic Surgery and Rehabilitation, University of Nebraska Medical Center, Omaha, NE, USA., Cornett C; Department of Orthopedic Surgery and Rehabilitation, University of Nebraska Medical Center, Omaha, NE, USA., Gannon E; Department of Orthopedic Surgery and Rehabilitation, University of Nebraska Medical Center, Omaha, NE, USA.
Jazyk:	angličtina
Zdroj:	Journal of spine surgery (Hong Kong) [J Spine Surg] 2023 Dec 25; Vol. 9 (4), pp. 472-478. Date of Electronic Publication: 2023 Dec 06.
DOI:	10.21037/jss-23-60
Abstrakt:	Background: Traumatic atlanto-occipital dislocation (AOD) is most commonly treated with cranio-cervical fusion. We present a unique case in which a partial neurological recovery was made after non-operative treatment was done for AOD. Reports of non-operative treatment of this condition are rare in the literature. Case Description: An 18-year-old male sustained a traumatic AOD and atlanto-axial dislocation. His injury was characterized by bony avulsion fractures of the occipital condyles bilaterally as well as atlanto-axial dissociation. Non-operative treatment was done because of his comorbidities, primarily his morbid obesity. He was treated in a hard cervical collar for 6 months. He showed radiographic evidence of healing after being treated non-operatively in a rigid cervical collar for 6 months. Follow up at 17 months showed a partial neurological recovery with ability to ambulate assisted with a walker. Conclusions: Successful outcomes are possible with non-operative treatment of AOD. A predominant factor contributing to this patient's successful outcome with non-operative management was likely related to the bony avulsion fractures he had which allowed bone to bone healing and settling of the fracture with gravity assisted reduction in a collar. Non-operative treatment may be considered in patients who are too unhealthy or unstable to undergo surgical intervention, although the standard of care remains surgical cranio-cervical fusion. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jss.amegroups.com/article/view/10.21037/jss-23-60/coif). The authors have no conflicts of interest to declare. (2023 Journal of Spine Surgery. All rights reserved.)
Databáze:	MEDLINE
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