Traumatic atlantoaxial distraction injury - A case report

Study Design: Case report. Objectives: Description of a rarely reported variant of traumatic C1-C2 dis location and discussion of a favorable outcome in a nonsurgical treatment a pproach. Summary of Background Data: Atlantoaxial dislocation most commonly involves an anterior movement of C1 in relation to C2. Often, the integrity of the transverse ligament or odontoid process is compromised, and the atlantodent al interval changed. The described patient sustained a purely craniocaudal atlantoaxial distractive lesion secondary to injury sustained in a high-spe ed motor vehicle accident. Results: The initial treatment plan involved surgical stabilization subsequ ent to healing of a C1 ring fracture. After 12 weeks of external stabilizat ion, ligamentous damage appeared well resolved. That there was no gross ins tability delayed using a surgical option. At periodic checkup, the patient was without symptoms. Conclusion: In this case, conservative management of a ligamentous C1-C2 in jury was effective. At 5 years after trauma the patient was without sequela e. This outcome is in contrast to previous management of injuries of this t ype, all of which involved surgical intervention.