Diagnosis and Management of Traumatic Atlanto-occipital Dislocation Injuries.

Academic Article

Abstract

  • DIAGNOSTIC: Standards There is insufficient evidence to support diagnostic standards. Guidelines There is insufficient evidence to support diagnostic guidelines. Options A lateral cervical x-ray is recommended for the diagnosis of atlanto-occipital dislocation. If a radiological method for measurement is used, the basion-axial interval-basion-dental interval method is recommended.The presence of upper cervical prevertebral soft tissue swelling on an otherwise nondiagnostic plain x-ray should prompt additional imaging.If there is clinical suspicion of atlanto-occipital dislocation, and plain x-rays are nondiagnostic, computed tomography or magnetic resonance imaging is recommended, particularly for the diagnosis of non-Type II dislocations. TREATMENT: Standards There is insufficient evidence to support treatment standards. Guidelines There is insufficient evidence to support treatment guidelines. Options Treatment with internal fixation and arthrodesis using one of a variety of methods is recommended. Traction may be used in the management of patients with atlanto-occipital dislocation, but it is associated with a 10% risk of neurological deterioration.
  • Published In

  • Neurosurgery  Journal
  • Digital Object Identifier (doi)

    Author List

  • Hadley MN; Walters BC; Grabb PA; Oyesiku NM; Przybylski GJ; Resnick DK; Ryken TC
  • Start Page

  • S105
  • End Page

  • S113
  • Volume

  • 50
  • Issue

  • suppl_3