Anterior atlantoaxial dislocation with odontoid fracture
Introduction
Introduction of atlantoaxial detachment with odontoid fracture Traumatic spasm-axial instability refers to the violent injury of the bone and ligament structure, loss of normal function and stability, can lead to atlantoaxial dislocation or subluxation, causing nerve compression symptoms. basic knowledge The proportion of illness: 0.005% Susceptible people: no specific people Mode of infection: non-infectious complication:
Cause
Causes of atlantoaxial anterior dislocation with odontoid fracture
(1) Causes of the disease
Mostly caused by violence that causes the head and neck to suddenly bend forward or from the back of the neck.
(two) pathogenesis
From the anatomy of the odontoid, there is a cusp ligament attached to the leading edge of the occipital foramen, and a wing-shaped ligament attached to the medial edge of the occipital condyle on both sides. This group of ligaments and the transverse ligament of the atlas maintains the neck. Stabilization and activity between the occipital and atlantoaxial joints, but if the head and neck flexed extremely forward, or ascended backwards, or violently rotated to the left and right, the ligaments were highly stressed, causing odontoid fractures, and With the inertia of violence, secondary dislocation of the atlantoaxial joint is secondary. Among them, the anterior dislocation caused by the forward flexion of the head and neck is more common; the posterior dislocation is relatively rare, but with the development of the expressway, the speed of the vehicle is increased and driven. The increasing number of vehicles is increasing, and this damage will increase.
After the odontoid fracture, because of its forward displacement with the atlas, the distance from the posterior edge of the upper end of the odontoid to the anterior border of the atlas is still intact, but the lower end is reduced, so the neck is compared with the posterior dislocation. The chance of myeloid pressure is relatively small, and the inner diameter of the atlas is wider, which gives the spinal cord a room for retreat (Figure 1).
If the odontoid dysplasia, including odontoid defect, poor healing and pseudo-articular formation, etc., it is more likely to occur. The closure time of the odontoid callus is generally 7-8 years old, which may cause the separation of the odontoid epiphysis before this.
Most of the odontoid fractures with dislocation are found in the base of the odontoid, and few fractures occur above.
Prevention
Prevention of atlantoaxial anterior dislocation with odontoid fracture
Prevention: Avoid violent trauma and pay attention to driving safety.
Complication
Complications of atlantoaxial anterior dislocation with odontoid fracture Complication
Sometimes it can be complicated by cervical spinal cord injury and quadriplegia; the odontoid does not heal.
Symptom
Symptoms of atlantoaxial anterior dislocation with odontoid fractures Common symptoms Paralysis of the neck, back muscles, complete cervical spinal cord injury, quadriplegia
It is similar to simple atlantoaxial joint dislocation, but the incidence of spinal nerve compression is relatively low, and to a lesser extent, but if the violence is too severe, it can still cause complete damage to the cervical spinal cord and severe quadriplegia. It even causes paralysis of the respiratory muscles and causes death.
1. The history of trauma is mostly the violence that causes the head and neck to suddenly bend forward, including the blow from the back of the head and neck, the fall of the neck from the height and the sudden flexion of the head and neck during the crash.
2. Clinical manifestations As mentioned above, local and neurological symptoms of the cervical vertebrae should be considered.
3. Imaging examination is mainly based on X-ray plain film, including orthostatic, lateral position and open position. However, in the case of emergency fracture, it is difficult to obtain the ideal open position film. CT and MRI can also be used. To determine the type of fracture, the congenital development of the odontoid process and the compression of the spinal cord.
Examine
Examination of atlantoaxial detachment with odontoid fracture
Mainly based on X-ray plain film, including the orthotopic, lateral and open position, but in the case of emergency fractures, it is difficult to obtain the ideal open position film, CT and MRI can also be used, mainly for the type of fracture, The congenital development of the odontoid process and the determination of the spinal cord compression.
Diagnosis
Diagnosis and diagnosis of atlantoaxial anterior dislocation with odontoid fracture
There is currently no relevant information.
