PMID- 22406773
OWN - NLM
STAT- MEDLINE
DCOM- 20120508
LR  - 20220316
IS  - 0028-3886 (Print)
IS  - 0028-3886 (Linking)
VI  - 60
IP  - 1
DP  - 2012 Jan-Feb
TI  - Atlantoaxial dislocation.
PG  - 9-17
LID - 10.4103/0028-3886.93582 [doi]
AB  - Atlanto-axial dislocations (AADs) may be classified into four varieties depending 
      upon the direction and plane of the dislocation i.e. anteroposterior, rotatory, 
      central, and mixed dislocations. However, from the surgical point of view these 
      are divided into two categories i.e. reducible (RAADs) and irreducible (IAADs). 
      Posterior fusion is the treatment of choice for RAAD. Transarticular screw 
      fixation with sub-laminar wiring is the most stable& method of posterior fusion. 
      Often, IAAD is due to inadequate extension in dynamic X-ray study which may also 
      be due to spasm of muscles. If the anatomy at the occipito-atlanto-axial region 
      O-C1-C2; O: occiput, C1: atlas, C2: axis is normal on X-ray, the dislocation 
      should be reducible. In case congenital anomalies at O-C1-C2 and IAAD are seen on 
      flexion/extension studies of the cervical spine, the C1-C2 joints should be seen 
      in computerized tomography scan (CT). If the C1-C2 joint facet surfaces are 
      normal, the AAD should be reducible by cervical traction or during surgery by 
      mobilizing the joints. The entity termed "dolichoodontoid" does not exist. It is 
      invariably C2-C3 (C3- third cervical vertebra) fusion which gives an appearance 
      of dolichoodontoid on plain X-ray or on mid-saggital section of magnetic 
      resonance imaging (MRI) or CT scan. The central dislocation and axial 
      invagination should not be confused with basilar invagination. Transoral 
      odontoidectomy alone is never sufficient in cases of congenital IAAD, adequate 
      generous three-dimensional decompression while protecting the underlying neural 
      structures should be achieved. Chronic post-traumatic IAAD are usually Type II 
      odontoid fractures which get malunited or nonunited with pseudoarthrosis in 
      dislocated position. All these dislocations can be reduced by transoral removal 
      of the offending bone, callous and fibrous tissue.
FAU - Jain, Vijendra K
AU  - Jain VK
AD  - Department of Neurosurgery, Sir Ganga Ram Hospital, Rajendra Nagar, New Delhi, 
      India. vkjneuro2004@yahoo.com
LA  - eng
PT  - Journal Article
PT  - Review
PL  - India
TA  - Neurol India
JT  - Neurology India
JID - 0042005
SB  - IM
MH  - Atlanto-Axial Joint/*pathology/surgery
MH  - Cervical Vertebrae
MH  - Humans
MH  - *Joint Dislocations/diagnosis/surgery
EDAT- 2012/03/13 06:00
MHDA- 2012/05/09 06:00
CRDT- 2012/03/13 06:00
PHST- 2012/03/13 06:00 [entrez]
PHST- 2012/03/13 06:00 [pubmed]
PHST- 2012/05/09 06:00 [medline]
AID - ni_2012_60_1_9_93582 [pii]
AID - 10.4103/0028-3886.93582 [doi]
PST - ppublish
SO  - Neurol India. 2012 Jan-Feb;60(1):9-17. doi: 10.4103/0028-3886.93582.