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Zhongguo Gu Shang 2019 Sep;32(9):819-823

Department of Orthopaedics, Changzheng Hospital Affiliated to Naval Military Medical University, Shanghai 200003, China;

Objective: To evaluate the effect of bilateral atlantoaxial lamina hook and atlantoaxial joint space screw combined with autologous iliac bone graft on atlantoaxial dislocation caused by acute type I transverse ligament injury in school-age children.

Methods: From February 2006 to February 2019, 8 school-age children with atlantoaxial dislocation caused by acute type I transverse ligament injury were systematically reviewed, including 6 males and 2 females; aged 9 to 12 years old; 8 acute injuries included 4 high-level falls, 2 car accidents and 2 sports injuries; the atlantoaxial interval(ADI) was 5 to 8 mm. Eight cases presented with pain, stiffness, numbness and cervical spine dysfunction in different degrees. Read More

Biomed Res Int 2019 18;2019:5297950. Epub 2019 Mar 18.

Department of Orthopaedics, Spine and Trauma Surgery, Helios Klinikum Siegburg, Siegburg, Germany.

Traumatic atlantoaxial dislocation due to ligamentous and combined osseous injuries rarely occurs in adults. There are only few cases published in the literature. In this level 4 study, a cohort of nine consecutive patients suffering from traumatic atlantoaxial dislocation has been analyzed regarding morphology of injury, trauma mechanism, and outcome since 2007. Read More

PM R 2019 04 19;11(4):440-445. Epub 2019 Feb 19.

Division of Neurosurgery, University of Missouri School Medicine, Columbia, MO 65212.

Individuals with spinal cord injury (SCI) have altered neurophysiology and present with symptoms that must be interpreted in the context of their specific neurologic injury. This is a case of a 16-year-old female adolescent with C5 American Spinal Injury Association Impairment Scale A SCI who presented with intractable nausea. Multiple etiologies for her nausea, including medication effect, metabolic and gastrointestinal disorders, autonomic dysreflexia, and mood disorder, were systematically ruled out. Read More

Br J Neurosurg 2018 Nov 19:1-4. Epub 2018 Nov 19.

b Department of Neurosurgery , Mie University Graduate School of Medicine , Tsu , Mie , Japan.

Purpose: Although dysphagia is known potential complication of cervical spine surgery, it rarely occurs after a posterior approach. We describe an unusual case of a retro-odontoid pseudotumor that suffered dysphagia following a C1 laminectomy and posterior atlantoaxial fixation.

Materials And Methods: A 79-year-old man presented with progressive tetraparesis and bladder and bowel dysfunction due to severe compression to cervical cord at C1 from a retro-odontoid pseudotumor. Read More

J Am Acad Orthop Surg 2019 Mar;27(5):e242-e248

From the Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Shaanxi, China.

Background: In theory, temporary posterior atlantoaxial screw-rod fixation for type II odontoid fractures is a way to preserve rotatory motion. However, the healing rate of type II odontoid fractures treated in this way is unknown; that is, the risk associated with conducting a temporary screw-rod fixation for type II odontoid fractures is unknown. This study investigates the healing rate of type II odontoid fractures treated with posterior atlantoaxial screw-rod fixation by CT imaging and evaluates the feasibility of conducting a temporary screw-rod fixation for type II odontoid fractures. Read More

Joint Bone Spine 2019 07 4;86(4):519-521. Epub 2018 Oct 4.

Rheumatology, Xarxa Universitària Fundació Althaia, Manresa, Joan Soler, 1-3, Manresa 08243, Barcelona, Spain.

Spine (Phila Pa 1976) 2019 03;44(5):E306-E314

Department of Spine Surgery, Center for Orthopedics, Daping Hospital, Army Medical University.

Detailed clinical information of 13 adult patients with acute atlantal fractures underwent nonoperative treatment was retrospectively studied. "Rule of Spence" was found inaccurate in predicting either integrity of transverse atlantal ligament (TAL) or atlantoaxial stability, whereas Dickman's classification of TAL injury was more superior to "rule of Spence" on both prediction.

Study Design: A retrospective study. Read More

World Neurosurg 2018 Oct 19;118:e925-e932. Epub 2018 Jul 19.

Department of Neurosurgery, Sahaydri Superspeciality Hospital, Nashik, Maharashtra, India.

Objective: Deliberate C2 nerve root sectioning and its preservation have been described during posterior fusion for atlantoaxial dislocation (AAD). However, the associated outcomes have been less studied, especially in congenital AAD. Our objective was to study the clinical outcomes after C2 nerve root sectioning and the feasibility of C2 preservation in these patients. Read More

Eur Spine J 2019 06 2;28(Suppl 2):9-12. Epub 2018 Jul 2.

Department of Neurosurgery, Southmead Hospital, Bristol, UK.

Purpose: Traumatic atlantoaxial dislocation (AAD) is usually associated with fatal high-velocity road traffic accidents (Xu et al. in Medicine (Baltimore) 94:e1768, 2015). There are few reports of survival following posterior AAD without odontoid fracture (Xu et al. Read More

Clin Neurol Neurosurg 2018 02 21;165:15-20. Epub 2017 Dec 21.

Neurosurgery, PGIMER, Chandigarh, India. Electronic address:

Objectives: Manifestation of congenital anomalies of cranio-vertebral junction (CVJ) in the later half of life is unusual and intriguing. Coexisting cervical spondylotic changes with multilevel compression, poorer bone quality as well as less smooth post-surgical recuperation make management of elderly Congenital Atlantoaxial Dislocation/ Basilar Invagination (CAAD/BI) challenging. The clinico-radiological presentation, pathogenesis and outcome are analysed here. Read More

Acta Orthop Traumatol Turc 2018 May 23;52(3):240-243. Epub 2017 Nov 23.

Department of Orthopaedic Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea. Electronic address:

Brown-Sequard syndrome is an uncommon complication of atlantoaxial arthrodesis. A 50-year-old female visited our emergency department after falling from a ladder. Radiologic evaluations revealed chronic C1-2 instability with acute spinal cord injury. Read More

Musculoskelet Sci Pract 2018 02 10;33:46-52. Epub 2017 Nov 10.

Discipline of Physiotherapy, The University of Newcastle, University Drive, Callaghan, 2308, NSW, Australia.

Background: Lateral atlantoaxial (LAA) joints are established sources of nociceptive input in chronic whiplash associated disorder (WAD). These joints contain intra-articular meniscoids that may be damaged in whiplash trauma. LAA joint meniscoid morphology has not been investigated comprehensively in a chronic WAD population, and it is unclear whether morphological differences exist compared to a pain-free population. Read More

Arch Orthop Trauma Surg 2017 Oct 29;137(10):1349-1355. Epub 2017 Aug 29.

Department of Orthopedics, The Second Affiliated Hospital, Chongqing Medical University, No. 76 Linjiang Road, Yuzhong District, Chongqing, 400010, People's Republic of China.

Introduction: Current surgical methods to treat atlantoaxial instability pose potential risks to the surrounding blood vessels and nerves of operative approach. Therefore, more secure and highly effective methods are expected. This study sought to assess the biomechanical efficacy of a novel unilateral double screw-rod fixation system by comparing with traditional and emerging fixation methods in cadaveric models. Read More

J Spine Surg 2017 Jun;3(2):267-271

1Division of Neurosurgery, Department of Surgery, 2Division of Neuroradiology, Department of Radiology, McMaster University, Hamilton, Ontario, Canada.

Atlantoaxial procedures have been developed in an effort to ensure solid C1-C2 fusion. However, techniques that involve sublaminar wiring have the potential for neural structure injury. We present the management of a patient who previously underwent Gallie fusion 10 years ago and is presenting with a dislodged titanium wire that has migrated into the medulla oblongata. Read More

Childs Nerv Syst 2017 Aug 6;33(8):1253-1260. Epub 2017 Jul 6.

Division of Pediatric Neurosurgery, Dell Children's Hospital, Austin, TX, USA.

Background: The treatment of atlantoaxial dislocation in very young children is challenging and lacks a consensus management strategy.

Discussion: We review the literature on infantile occipitocervical (OC) fusion is appraised and technical considerations are organized for ease of reference. Surgical decisions such as graft type and instrumentation details are summarized, along with the use of bone morphogenic protein and post-operative orthoses. Read More

Z Orthop Unfall 2017 Jun 6;155(3):318-323. Epub 2017 Jul 6.

Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Uniklinik Köln.

The odontoid process and the transverse ligament are the most important structures stabilising the atlantoaxial complex. It has not been fully elucidated how injuries of these structures contribute towards instability and a potential narrowing of the spinal canal. Therefore, our investigation aimed to perform a biomechanical analysis of spinal width and dislocation of the odontoid process depending on injuries of the aforementioned structures. Read More

Osteoporos Int 2017 06 2;28(6):1931-1938. Epub 2017 Mar 2.

Department of Neurosurgery, Hanyang University Medical Center, 222-1, Wangsimni-ro, Seongdong-gu, Seoul, 133-792, South Korea.

Osteopenia and osteoporosis were independent predictive factors for higher atlantoaxial subluxation occurrence in patients with lower body mass index. Our findings suggest that patients with rheumatoid arthritis with osteopenia or osteoporosis, particularly those with lower body mass index (BMI), should be screened regularly to determine the status of their cervical spines.

Introduction: Cervical spine involvement in rheumatoid arthritis (RA) patients may cause serious adverse effects on quality of life and overall health. Read More

Biomed Eng Online 2016 Dec 28;15(Suppl 2):168. Epub 2016 Dec 28.

School of Biomedical Engineering, Capital Medical University, Beijing, 100069, China.

Background: Basilar invagination (BI) combined with atlantoaxial dislocation (AAD) leads to foramen magnum stenosis and medullary spinal cord compression, causing nerve dysfunction. The purpose of the surgery is to remove the bony compression at brainstem ventral side and fix the unstable spinal segment and make it fused stably. Occipital cervical internal fixation system that simultaneously reduces atlantoaxial horizontal and vertical dislocation are established. Read More

J Orthop Sci 2017 Mar 12;22(2):213-217. Epub 2016 Nov 12.

Department of Orthopedic Surgery, Tokyo Women's Medical University, Tokyo, Japan.

Background: C1 lateral mass screw was widely used for fixation of the upper cervical spine. However, massive bleeding from the C1-2 venous plexus is sometimes encountered. In this study, we proposed an alternate method for C1 lateral mass screw insertion, which involves insertion of the screws caudally from the C2 nerve root to reduce bleeding from C1-2 venous plexus. Read More

World Neurosurg 2016 Sep 23;93:293-8. Epub 2016 Jun 23.

Department of Orthopedics, The Second Affiliated Hospital, The Second Military Medical University, Shanghai, China. Electronic address:

Objective: To evaluate the biomechanical stability of 3 atlantoaxial proactive vertebral artery injury prevention fixation combinations.

Methods: We used 6 fresh human cadaveric C0-C4 specimens for the biomechanical test with moment control in 6 loading directions. First, range of motion (ROM) was measured in the intact specimens before they were destabilized; next, ROM of the 4 conditions fixed with 4 different fixation combinations were tested in alternating sequence: bilateral transarticular screw (TAS) and 3 test combinations: C1 laminar hook (C1LH) and C2 intralaminar screw (C2ILS) on 1 side combined with TAS (C1LH-C2ILS/TAS) or C1LH and TAS (C1LH-C2ILS/C1LH-TAS) or C1LH and C2ILS on the other side (C1LH-C2ILS/C1LH-C2ILS). Read More

Zhonghua Yi Xue Za Zhi 2015 Sep;95(35):2829-33

Department of Spinal Surgery, the First Affiliated Hospital of Xinjiang Medical University, Xinjiang Urmuqi 830054, China; Email:

Objective: To evaluate the indications and effect of surgical treatment of basilar invagination (BI) with atlantoaxial dislocation (AAD) on the basis of retrospective analysis of the clinical and imaging data of patients.

Methods: Consecutive 21 patients with BI and AAD were surgically treated in Department of Spinal Surgery, The First Affiliated Hospital of Xinjiang Medical University from July 2000 to December 2013. There were 10 males and 11 females, aged from 7 to 59 years, with a mean of 36. Read More

Spine (Phila Pa 1976) 2016 Jun;41(12):E725-32

*Orthopaedic Department, Peking University Third Hospital, Beijing, China †Division of Spinal Surgery, NYU Medical Center/Hospital for Joint Diseases, NYU school of Medicine, New York, NY.

Study Design: Retrospective case series of atlantoaxial rotatory fixed dislocation (AARFD).

Objective: To describe clinical features and the surgical treatment of AARFD.

Summary Of Background Data: The classification and treatment strategy for atlantoaxial rotatory fixation (AARF) were previously described and remained controversial. Read More

Semin Arthritis Rheum 2015 Aug 5;45(1):9-17. Epub 2015 Mar 5.

Department of Rheumatology (Planta 10-2), Hospital Universitario de Bellvitge-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, Barcelona 08907, Spain.

Objective: To investigate the frequency, location, characteristics, and clinical significance of subaxial involvement (below C1-C2) in a series of patients with rheumatoid arthritis (RA) and symptomatic involvement of the cervical spine.

Methods: A total of 41 patients with RA were examined via cervical spine magnetic resonance imaging (MRI). A comparative analysis of the incidence of the different types of subaxial lesions was performed between these patients and 41 age- and sex-matched patients with symptomatic cervical spondylosis. Read More

Mod Rheumatol 2017 Sep 29;27(5):901-904. Epub 2015 Jun 29.

a Department of Orthopedic Surgery , Hokkaido University Graduate School of Medicine , Sapporo , Japan.

To highlight the risk of cervical myelopathy due to occult, atraumatic odontoid fracture in patients with rheumatoid arthritis, we retrospectively reviewed radiographic findings and clinical observations for 7 patients with this disorder. This fracture tends to occur in patients with long-lasting rheumatoid arthritis and to be misdiagnosed as simple atlantoaxial dislocation. Since this fracture causes multidirectional instability between C1 and C2 and is expected to have poor healing potential due to bone erosion and inadequate blood supply, posterior spinal arthrodesis surgery is indicated upon identification of the fracture to prevent myelopathy. Read More

Spine J 2015 Jul 7;15(7):1618-28. Epub 2015 Feb 7.

MERC (Musculoskeletal Education and Research Center), Globus Medical, Inc., 2560 General Armistead Ave., Audubon, PA 19403, USA.

Background Context: Occipitocervical dislocations involve translations of the craniocervical joints. The relative contributions of each ligament to overall stability and the effects of the occipitoatlantal joint capsules on the pathologic translation are unknown. Although incidences of occipitocervical dislocations are rare after blunt trauma, they are usually fatal. Read More

Eur Spine J 2015 Apr 28;24(4):686-93. Epub 2014 Dec 28.

Department of Orthopedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jie Fang Road, Hangzhou, 310009, Zhejiang, People's Republic of China.

Purpose: To assess the feasibility of temporary pedicle screw fixation for motion preservation of type II odontoid fractures unsuitable for anterior screw.

Methods: Between 2012 and 2013, temporary pedicle screw fixation was performed in 13 patients with type II odontoid fractures unsuitable for anterior screw. The patients were 10 men and 3 women with an average age of 40. Read More

World Neurosurg 2015 Jun 19;83(6):1180.e1-6. Epub 2014 Dec 19.

Department of Orthopedics, Xinqiao Hospital, The Third Military Medical University, Chongqing, China.

Objective: Os odontoideum can lead to instability of the atlantoaxial joint and places the spinal cord at significant risk for acute traumatic catastrophic events or chronic neurologic change. The purpose of this study was to retrospectively review acute cervical cord injury after minor trauma in 6 pediatric patients with os odontoideum.

Methods: Between 2012 and 2013, 6 pediatric patients with os odontoideum who suffered acute traumatic cervical cord injury were reviewed retrospectively. Read More

Mol Genet Metab 2015 Jan 30;114(1):11-8. Epub 2014 Oct 30.

Department of Anesthesiology & Critical Care, Nemours/Alfred I. duPont Hospital for Children, 1600 Rockland Road, Wilmington, DE 19803-3607, USA. Electronic address:

Mucopolysaccharidosis IVA is an autosomal recessive condition caused by mutations in the GALNS gene, which encodes N-acetylgalactosamine-6-sulfatase, also called galactosamine-6-sulfatase (GALNS). A reduction in or absence of effective GALNS leads to faulty catabolism of keratan sulfate and chondroitin-6-sulfate within the lysosome; their accumulation causes cell, tissue, and organ dysfunction. The connective tissue, cartilage, ligaments, and bone of patients with Morquio A syndrome are particularly affected. Read More

Skeletal Radiol 2015 Feb 18;44(2):241-8. Epub 2014 Sep 18.

Department of Radiology, Uppsala University Hospital, 751 85, Uppsala, Sweden,

Objective: To compare CR with CT (static and dynamic) to evaluate upper spine instability and to determine if CT in flexion adds value compared to MR imaging in neutral position to assess compression of the subarachnoid space and of the spinal cord.

Materials And Methods: Twenty-one consecutive patients with atlantoaxial subluxation due to rheumatoid arthritis planned for atlantoaxial fusion were included. CT and MRI were performed with the neck in the neutral position and CT also in flexion. Read More

Int J Rheum Dis 2018 Nov 8;21(11):2041-2045. Epub 2014 Sep 8.

Deparment ofNeurosurgery, University of Pamukkale, Denizli, Turkey.

We aim to draw attention to occult, atraumatic fractures of the odontoid process in patients with rheumatoid arthritis (RA) and to underline difficulties encountered during clinical and radiological diagnosis. A forty-seven years old man with RA for 4 years had occipital pain for 1 year without any history of trauma. Later, he developed weakness in the upper extremities, but he did not realize weakness in the lower extremities due to deformities. Read More

Curr Pain Headache Rep 2014 Sep;18(9):442

Thomas Jefferson University Hospital, 834 Chestnut Street T150, Philadelphia, PA, 19454, USA.

Cervicogenic headache (CGH) is defined as referred pain from various cervical structures innervated by the upper three cervical spinal nerves. Such structures are potential pain generators, and include the atlanto-occipital joint, atlantoaxial joint, C2-3 zygapophysial joint, C2-3 intervertebral disc, cervical myofascial trigger points, as well as the cervical spinal nerves. Various interventional techniques, including cervical epidural steroid injection (CESI), have been proposed to treat this disorder. Read More

Global Spine J 2014 Aug 13;4(3):179-86. Epub 2014 Jan 13.

Praça Vilagran Cabrita, School of Medicine Nova Esperança, João Pessoa, Paraíba, Brazil.

Study Design Case report and literature review. Objective To describe a case of nontraumatic atlantoaxial rotatory subluxation (Grisel syndrome) and to review clinical and radiologic aspects, physiopathology, and treatment of this lesion. There is no well-established protocol in the management of patients without spontaneous reduction. Read More

J Pediatr Rehabil Med 2013 ;6(3):175-80

Physical Medicine, Rehabilitation, and Sports Medicine Department, University of Puerto Rico, San Juan, Puerto Rico.

Purpose: The objective of this paper is to present a case series of patients with diagnosis of torticollis due to Grisel's syndrome and, in doing so, raise awareness of an unusual condition that could be fatal. A review of the literature is presented regarding diagnosis and treatment.

Methods: Case series of three patients that were 7, 10, and 12 years old with history of tonsillitis or neck surgery consulted to the service of Rehabilitation Medicine. Read More

J Neurosurg Spine 2013 Dec 20;19(6):688-93. Epub 2013 Sep 20.

Zentrum für Wirbelsäulenchirurgie, Orthopaedie, und Traumatologie; and.

Object: Surgical treatment of atlantoaxial injuries may be performed by a variety of surgical procedures, with each of these having its own specific advantages and disadvantages. To preserve the range of motion within the atlantoaxial joint after surgical treatment, posterior atlantoaxial screw fixation according to the method of Goel and Harms could be beneficial. This technique is not considered to fix the joint permanently if the screws are removed. Read More

J Stroke Cerebrovasc Dis 2013 Nov 2;22(8):e676-81. Epub 2013 Aug 2.

Department of Neurology, Juntendo University Urayasu Hospital, Chiba, Japan.

We report a 78-year-old woman with rheumatoid arthritis who developed recurrent embolic cerebellar strokes associated with vertical atlantoaxial subluxation (AAS). On contrast angiography, the bilateral vertebral arteries (VAs) were occluded between the C1 and C2 levels, and the distal parts of bilateral VA were supplied by the collateral circulations. Dynamic cerebral angiography and carotid duplex ultrasonography showed that blood flow was substantially decreased in the left VA and left posterior inferior cerebellar artery on cervical anteflexion. Read More

Spine (Phila Pa 1976) 2013 Oct;38(22):E1397-404

From the Department of Orthopaedic Surgery, Shengjing Hospital of China Medical University, Shenyang City, Liaoning Province, P.R. China.

Study Design: Anatomical measurements and in vitro biomechanical testing were performed to evaluate a new method for posterior C1 fixation.

Objective: This study sought to assess C1 posterior arch crossing screw fixation for posterior C1-C2 fixation, using anatomical measurements and biomechanical testing with traditional C1 pedicle screws (PS) in a cadaveric model.

Summary Of Background Data: Atlantoaxial instability often requires surgery, and the current methods for atlas fixation incur some risk to the vascular and neurological tissues. Read More

Am J Sports Med 2013 Aug 13;41(8):1915-21. Epub 2013 Jun 13.

Department of Orthopaedics, Tokyo Kosei Nenkin Hospital, 5-1 Tsukudo-cho Shinjuku-ku, Tokyo, 162-8543, Japan.

Background: Few studies have documented catastrophic head and neck injuries in judo, but these injuries deserve greater attention.

Purpose: To determine the features of catastrophic head and neck injuries in judo.

Study Design: Descriptive epidemiological study. Read More

Zhongguo Gu Shang 2012 Nov;25(11):915-9

Research Center of Upper Cervical Vertebrae, China-Japan Firendship Hospital, Ministry of Public Health, Beijing 100029, China.

Objective: To research the correlation between surgical treatment for atlantoaxial dislocation and dredging Governor vessel.

Methods: From June 2004 to June 2010,113 patients were reviewed, including 65 males and 48 females, with the mean age of 42.6 years (ranged, 8 to 64 years). Read More

J Am Acad Orthop Surg 2013 Jan;21(1):12-22

Seattle Children's Hospital, WA, USA.

The mucopolysaccharidoses (MPSs) are a family of disorders characterized by the accumulation of glycosaminoglycans, which is caused by enzyme deficiencies in the lysosomal metabolism of these normal cellular byproducts. Skeletal abnormalities are early and prominent features of MPS, and the orthopaedic surgeon is often the first healthcare provider to raise suspicion for this diagnosis. Recently developed medical therapies for the management of MPS (ie, hematopoietic stem cell transplantation, intravenous enzyme replacement therapy) have led to increased lifespan but have not had much effect on the development of skeletal deformities. Read More

J Clin Neurosci 2013 Jan 30;20(1):162-7. Epub 2012 Oct 30.

Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul 135-710, Republic of Korea.

For the past decade, a screw-rod construct has been used commonly to stabilize the atlantoaxial joint, but the insertion of the screw through the C1 lateral mass (LM) can cause several complications. We evaluated whether using a higher screw entry point for C1 lateral mass (LM) fixation than in the standard procedure could prevent screw-induced occipital neuralgia. We enrolled 12 consecutive patients who underwent bilateral C1 LM fixation, with the modified screw insertion point at the junction of the C1 posterior arch and the midpoint of the posterior inferior portion of the C1 LM. Read More

CNS Neurosci Ther 2012 Oct 20;18(10):876-7. Epub 2012 Aug 20.

Zhonghua Yi Xue Za Zhi 2012 May;92(17):1198-200

Department of Orthopedic Surgery, First Affiliated Hospital, Shanghai Jiaotong University, Shanghai 200080, China.

Objective: To explore the three-dimensional movement of atlantoaxial joint, complete transverse ligament and cracked transverse ligament after posterior atlantoaxial fixation.

Methods: The fresh upper cervical cadaveric specimens were collected from 6 males dead from active craniocerebral injury. The average age was 39. Read More

Zhonghua Wai Ke Za Zhi 2012 Mar;50(3):247-50

Department of Orthopaedics, Wuhan General Hospital of Guangzhou Command of People's Liberation Army, Wuhan 430070, China.

Objective: To analyze appropriate strategy about treatment of rotatory dislocation of atlantoaxial articulation in children.

Methods: From March 2005 to February 2009, 36 patients with rotatory dislocation of atlantoaxial articulation were retrospectively analyzed, including 25 males and 11 females, with the average age of 7.8 years (ranged 3 - 14 years). Read More

J Spinal Cord Med 2012 Mar;35(2):125-7

Jefferson Medical College, Philadelphia, PA, USA.

Study Design: Case report.

Objective: To report a case of cervical instability from an os odontoideum that presented as posterior thoracic pain and to present a review of the literature.

Background: Thoracic posterior paraspinal spasms and pain are common chief complaints in individuals with spinal abnormalities. Read More

Injury 2012 Jul 4;43(7):1212-5. Epub 2012 Feb 4.

Department of Trauma and Orthopaedics, University Hospitals of Leicester, Infirmary Square, Leicester, UK.

Mod Rheumatol 2012 Sep 14;22(5):743-9. Epub 2012 Jan 14.

Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.

We reviewed 101 rheumatoid arthritis (RA) patients who had undergone their first lower limb arthroplasty between 1990 and 2002. None of the patients had received immunosuppressant or biological drugs. Preoperative and follow-up cervical spine radiographs had been performed (more than 2 years after the arthroplasty). Read More

World Neurosurg 2012 Dec 1;78(6):697-708. Epub 2011 Nov 1.

Neurosurgical Care, LLC, Royersford, Pennsylvania, USA.

Objective: To review published series describing C1-2 posterolateral instrumentation, comparing outcomes in patients who had and did not have C2 nerve sacrifice.

Methods: Online databases were searched for English-language articles between 1994 and April 2011 pertaining to posterior atlantoaxial instrumentation with C1 lateral mass and C2 screws. Twenty studies describing 732 patients with C2 nerve preservation and 6 studies describing 361 patients with C2 sacrifice met inclusion criteria. Read More

World Neurosurg 2012 Jul 7;78(1-2):170-7. Epub 2011 Nov 7.

Department of Neurosurgery, New York University Langone Medical Center, Bellevue Hospital, New York, New York, USA.

Objective: To analyze qualitatively C2 nerve dysfunction after its transection in C1-2 posterolateral instrumented fusions.

Methods: From 2002-2010, 20 consecutive patients underwent posterolateral instrumented fusions using C1 lateral mass and C2 pars or pedicle screws, mainly for type 2 dens fractures. Screws were placed under lateral fluoroscopic guidance using standard techniques. Read More

Orthop Clin North Am 2012 Jan;43(1):11-8, vii

Department of Orthopaedics, The Ohio State University, 4110 Cramblett Hall, Columbus, OH 43210, USA.

The atlantoaxial motion segment, which is responsible for half of the rotational motion in the cervical spine, is a complex junction of the first (C1) and second (C2) cervical vertebrae. Destabilization of this joint is multifactorial and can lead to pathologic motion with neurologic sequelae. Posterior spinal fixation of the C1-C2 articulation in the presence of instability has been well described in the literature. Read More

Bull NYU Hosp Jt Dis 2011 ;69(2):136-48

Departmentof Sports Medicine, University of Pittsburgh Medical Center, Pennsylvania, USA.

Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disorder affecting multiple organ systems, joints, ligaments, and bones and commonly involves the cervical spine. Chronic synovitis may result in bony erosion and ligamentous laxity that result in instability and subluxation. Anterior atlantoaxial subluxation (AAS) is the most frequently occurring deformity, due to laxity of the primary and secondary ligamentous restraints. Read More