Traumatic atlanto-occipital dislocation in children

Nelson Astur, Jeffrey R. Sawyer, Paul Klimo, Derek M. Kelly, Michael Muhlbauer, William C. Warner

Research output: Contribution to journalReview article

6 Citations (Scopus)

Abstract

Although once considered an invariably fatal injury, improvements in diagnosis and management have made atlanto-occipital dislocation (AOD) a survivable injury. MRI is the preferred imaging modality; occasionally, flexion/extension/distraction fluoroscopy may be required to determine craniovertebral stability. Early surgical stabilization is recommended for all children with AOD. Early occipitocervical fusion using screws in combination with a rod or plate, or sublaminar wires with a contoured rod, coupled with autograft bone, provide immediate stabilization and a high fusion rate. Halo immobilization and traction are contraindicated in the management of AOD in children because of the risk of displacement of the injured occipitocervical joint. Postoperative hydrocephalus is frequent and should be suspected when neurologic decline occurs after fixation. Nearly half of children who survive AOD will have residual neurologic deficits.

Original languageEnglish (US)
Pages (from-to)274-282
Number of pages9
JournalJournal of the American Academy of Orthopaedic Surgeons
Volume22
Issue number5
DOIs
StatePublished - Jan 1 2014

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Fluoroscopy
Autografts
Wounds and Injuries
Traction
Hydrocephalus
Neurologic Manifestations
Immobilization
Nervous System
Joints
Bone and Bones

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Traumatic atlanto-occipital dislocation in children. / Astur, Nelson; Sawyer, Jeffrey R.; Klimo, Paul; Kelly, Derek M.; Muhlbauer, Michael; Warner, William C.

In: Journal of the American Academy of Orthopaedic Surgeons, Vol. 22, No. 5, 01.01.2014, p. 274-282.

Research output: Contribution to journalReview article

Astur, Nelson ; Sawyer, Jeffrey R. ; Klimo, Paul ; Kelly, Derek M. ; Muhlbauer, Michael ; Warner, William C. / Traumatic atlanto-occipital dislocation in children. In: Journal of the American Academy of Orthopaedic Surgeons. 2014 ; Vol. 22, No. 5. pp. 274-282.
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