atlantoaxial rotational dislocation fixation
Introduction
Brief introduction of atlantoaxial rotation and dislocation fixation The essence of atlantoaxial rotation and dislocation fixation is old dislocation. Fielding (1977) refers to the atlantoaxial rotatory subluxation state that occurs after spontaneous or mild trauma. Later (1983) he was also known as the rotation dislocation. Atlantoaxial joint dislocation and fixation were characterized by idiopathic torticollis, head and neck stiffness and rotation limitation, and the lesions of the odontoid and atlanto-vertebral lateral block were changed to X-ray features. Often misdiagnosed because of clinical neglect. basic knowledge The proportion of illness: 0.004%-0.008% Susceptible people: no specific population Mode of infection: non-infectious Complications: thrombosis
Cause
Fixed cause of atlantoaxial rotation and dislocation
The following theories about the cause of this disease:
1. Infection theory:
Upper respiratory tract infection can occur. Atlantoaxial congestive decalcification causes the associated ligament to loosen from its attachment and cause dislocation.
2. Trauma theory:
Most minor trauma, does not cause bone damage, resulting in the transverse ligament of the atlas, tearing of the ligament, forming instability of the atlantoaxial joint.
Whether it is trauma or infection, the joint capsule has synovial fluid exudation, swelling and muscle contracture. It can not return to normal anatomical alignment for a long time, resulting in contraction of the ligament and joint capsule to form rotational dislocation and fixation.
Prevention
Atlantoaxial rotation and dislocation fixation prevention
Atlantoaxial rotation and dislocation fixation is one of the complications of atlantoaxial rotation and dislocation. It is mainly characterized by recurrent episodes of dislocation and head and neck deflection. Therefore, the prevention of this disease is mainly to actively treat atlantoaxial spine dislocation and prevent it from being repeated. The attack forms the disease.
Complication
Atlantoaxial rotation and dislocation fixation complications Complications thrombosis
In the early stage, the disease mainly caused complications such as neck stiffness, pain, and limited head movement. In some patients, the distance between the caries can be widened, the diameter of the spinal canal becomes smaller, and the dural sac is compressed. The consequences will be severe. When the atlantoaxial rotatory subluxation does not take effective measures and spinal cord compression or vertebral artery thrombosis occurs, it is likely to cause death. For some serious patients, paraplegia and paraplegia will occur concurrently. And other complications.
Symptom
Atlantoaxial spine dislocation fixed symptoms Common symptoms Neck stiffness occipital pain Spasmodic torticollis dislocation Head and neck activity restricted
The main manifestations of this disease are:
1. Idiopathic torticollis: The torticollis is characterized by a 20° tilt to one side and a slight flexion, which is a male robin posture, and the long-term torticollis causes asymmetry in the head and face.
2, neck stiffness: the patient's head and neck rotation function is limited.
3. Pain: There is pain in the neck of the pillow.
4, limited activities: head and neck fixed.
Examine
Atlantoaxial rotation and dislocation fixation examination
The auxiliary examination method of this disease is mainly X-ray examination. X-ray plain film indicates that the anatomical relationship between the odontoid process and the lateral mass of the atlas is broken, and the caries distance changes. Fielding divides the atlantoaxial joint rotation and fixation into four types:
Type I is not associated with rotation and fixation of anterior dislocation of the vertebral body (displacement distance is less than 3 mm), indicating that the transverse ligament of the atlas is not damaged, and the range of rotational motion of the atlantoaxial is normal.
Type II rotation fixed displacement is 3mm ~ 5mm, may be combined with transverse ligament injury, one side of the side block is displaced, and the corresponding side block is unchanged, the atlantoaxial movement is beyond the normal range.
Type III is severely displaced, the atlas is displaced forward by more than 5 mm, and ADI exceeds the normal range.
IV type posterior sacral displacement, may only have one side of the block displacement, clinically rare, X-ray film may have difficulty in identifying its changes, especially the lateral piece is more difficult to judge, the open piece can show the side block Positioning forward and leaning toward the midline, the spinous process is biased to one side, and the opening position may also indicate that the facet joint has a "blinking eye" on the non-injured side and a partial overlap of the injured joint of the neck 1 to 3.
The degree and direction of rotation can be judged from the front and back tomograms and CT scans.
Diagnosis
Diagnosis and diagnosis of atlantoaxial rotation and dislocation
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
The disease mainly needs to be differentiated from cervical spondylosis. Cervical spondylosis is a syndrome of a series of clinical symptoms caused by cervical disc degeneration and cervical vertebrae hyperplasia. The clinical manifestations are neck, shoulder arm, scapular upper back and chest. Area pain, numbness of the arm, muscle atrophy, and even quadriplegia can occur at any age, with more than 40 years old and older, and the two diseases can be identified by X-ray and CT examination.
