TRAUMATIC ATLANTOAXIAL ROTATORY SUBLUXATION AND DISLOCATION

Study Design. This is a retrospective single-patient case report with a literature review. Objective. To report on a neurologically intact adult with bilateral traumatic atlantoaxial rotatory subluxation/dislocation and associated facet fracture, and present a review of the literature. Summary of Background Data. Unilateral rotatory dislocation is relatively common at the atlantoaxial articulation. On the contrary, atlantoaxial rotatory subluxation with bilateral facet dislocation is uncommon, particularly in adults. Periodic reports have appeared in the literature regarding this entity in children, but only two previous citations have involved adults. Methods. The patient was followed-up through personal examination and chart review from initial presentation to 5 months after discharge. Results. Closed reduction with cervical traction was followed by surgical fusion with stable repair and no neurologic deficits over 5 months follow-up. Conclusions. Traumatic bilateral atlantoaxial rotatory subluxation is uncommon in adults. This probably is due to the unique biomechanical features of the atlantoaxial articulation and the probable lethality of injury to the adjacent medulla or vertebral arteries before presentation at the trauma center.