PMID- 26660673
OWN - NLM
STAT- MEDLINE
DCOM- 20170424
LR  - 20181113
IS  - 1863-9941 (Electronic)
IS  - 1863-9933 (Linking)
VI  - 42
IP  - 6
DP  - 2016 Dec
TI  - It is the lateral head tilt, not head rotation, causing an asymmetry of the 
      odontoid-lateral mass interspace.
PG  - 749-754
AB  - OBJECTIVE: Asymmetry in odontoid-lateral mass interspace in trauma patients is a 
      common finding that regularly leads to additional diagnostic work-up, since its 
      dignity is not entirely clear. There is little evidence in the literature that 
      atlantoaxial asymmetry is associated with C1-C2 instability or (sub) luxation. 
      Asymmetry in odontoid-lateral mass interspace seems to occur occasionally in 
      healthy individuals and patients suffering a cervical spine injury. Congenital 
      abnormalities in odontoid-lateral mass asymmetry may mimic an atlantoaxial 
      asymmetry. The center of C1-C2 rotation is based in the peg of dens axis; 
      therefore, a C1-C2 rotational influence seems unlikely. So far, no study examined 
      the influence of C0-C1-C2 tilt to an asymmetry in odontoid-lateral mass 
      interspace. SUBJECTS AND METHODS: In order to determine if rotation or tilt 
      influences the lateral atlantodental interval (LADI) and to estimate physiologic 
      values, we examined 300 CT scans of the cervical spine. RESULTS: The mean LADI 
      was 3.57 mm and the mean odontoid-lateral mass asymmetry was 1.0 mm. Head 
      position during CT examination was found to be rotated in 39 % of the cases in 
      more than 5 degrees . Subsequent mean C0/C2 rotation was 4.6 degrees . There was no significant 
      correlation between atlantoaxial asymmetry and head rotation (p = 0.437). The 
      average tilt of C0-C1-C2 was found to be 2 degrees . We found a significant correlation 
      between tilt of C0-C1-C2 and asymmetry in odontoid-lateral mass interspace 
      (p = 0.000). CONCLUSION: We conclude that an atlantoaxial asymmetry revealed in 
      CT scans of the cervical spine occurs occasionally. Since head tilt correlates 
      with an atlantoaxial asymmetry, it is crucial to perform cervical spine CT scans 
      in a precise straight head position.
FAU - Guenkel, S
AU  - Guenkel S
AD  - Division of Trauma Surgery, University Hospital Zurich, Raemistrasse 100, 8091, 
      Zurich, Switzerland. sebastian.guenkel@usz.ch.
FAU - Scheyerer, M J
AU  - Scheyerer MJ
AD  - Division of Trauma Surgery, University Hospital Zurich, Raemistrasse 100, 8091, 
      Zurich, Switzerland.
FAU - Osterhoff, G
AU  - Osterhoff G
AD  - Division of Trauma Surgery, University Hospital Zurich, Raemistrasse 100, 8091, 
      Zurich, Switzerland.
FAU - Wanner, G A
AU  - Wanner GA
AD  - Division of Trauma Surgery, University Hospital Zurich, Raemistrasse 100, 8091, 
      Zurich, Switzerland.
FAU - Simmen, H-P
AU  - Simmen HP
AD  - Division of Trauma Surgery, University Hospital Zurich, Raemistrasse 100, 8091, 
      Zurich, Switzerland.
FAU - Werner, C M L
AU  - Werner CM
AD  - Division of Trauma Surgery, University Hospital Zurich, Raemistrasse 100, 8091, 
      Zurich, Switzerland.
LA  - eng
PT  - Journal Article
DEP - 20151211
PL  - Germany
TA  - Eur J Trauma Emerg Surg
JT  - European journal of trauma and emergency surgery : official publication of the 
      European Trauma Society
JID - 101313350
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cervical Vertebrae/*diagnostic imaging/*physiology
MH  - Female
MH  - Head Movements/*physiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Odontoid Process/*diagnostic imaging/*physiology
MH  - Retrospective Studies
MH  - Rotation
MH  - *Tomography, X-Ray Computed
OTO - NOTNLM
OT  - Asymmetry
OT  - Atlantoaxial
OT  - Cervical spine injury
OT  - Head rotation, head tilt
OT  - LADI
OT  - Odontoid-lateral mass interspace
EDAT- 2015/12/15 06:00
MHDA- 2017/04/25 06:00
CRDT- 2015/12/15 06:00
PHST- 2015/07/16 00:00 [received]
PHST- 2015/11/16 00:00 [accepted]
PHST- 2015/12/15 06:00 [pubmed]
PHST- 2017/04/25 06:00 [medline]
PHST- 2015/12/15 06:00 [entrez]
AID - 10.1007/s00068-015-0602-0 [pii]
AID - 10.1007/s00068-015-0602-0 [doi]
PST - ppublish
SO  - Eur J Trauma Emerg Surg. 2016 Dec;42(6):749-754. doi: 10.1007/s00068-015-0602-0. 
      Epub 2015 Dec 11.