Nontraumatic atlantoaxial rotatory subluxation in adults: Report of two cases

Xiaochun Zhao; Kiana Y Prather; José M Orenday-Barraza; Fauziyya Y Muhammad; Lance M Villeneuve; María José Cavagnaro; Ali A Baaj; Nader S Dahdaleh; Zachary A Smith

doi:10.25259/SNI_936_2022

Nontraumatic atlantoaxial rotatory subluxation in adults: Report of two cases

Surg Neurol Int. 2022 Dec 23:13:589. doi: 10.25259/SNI_936_2022. eCollection 2022.

Authors

Xiaochun Zhao¹, Kiana Y Prather¹, José M Orenday-Barraza², Fauziyya Y Muhammad¹, Lance M Villeneuve¹, María José Cavagnaro², Ali A Baaj², Nader S Dahdaleh³, Zachary A Smith¹

Affiliations

¹ Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
² Department of Neurosurgery, University of Arizona College of Medicine, Phoenix, Arizona.
³ Department of Neurological Surgery, Northwestern Medicine, Lavin Family Pavilion, Chicago, Illinois, United States.

Abstract

Background: Nontraumatic infectious atlantoaxial rotatory subluxation (AARS) is rare and less frequently encountered in adults versus children. We utilized a stepwise approach to treat two adults with nontraumatic infectious AARS and summarized the relevant literature.

Case description: Two patients, ages 35 and 66, presented with classic clinical and imaging findings for infectious nontraumatic AARS. Here, we summarized the management for these two patients along with the literature.

Conclusion: Nontraumatic infectious AARS in adults requires prompt X-ray diagnosis and timely application of traction to minimize neurological deficits. MR/CT imaging next offers critical information regarding whether operative stabilization is warranted.

Keywords: Atlantoaxial; Cock-robin; Grisel syndrome; Nontraumatic; Subluxation.

Publication types

Case Reports