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Erschienen in: Child's Nervous System 8/2016

25.05.2016 | Review Paper

Traumatic atlanto-occipital dislocation: do children and adolescents have better or worse outcomes than adults? A narrative review

verfasst von: R. Shane Tubbs, Chirag Patel, Marios Loukas, Rod J. Oskouian, Jens R. Chapman

Erschienen in: Child's Nervous System | Ausgabe 8/2016

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Abstract

Background

Traumatic atlanto-occipital dislocation is an uncommon, severely unstable pathology, which can lead to detrimental or even fatal neurological impairment. Specifically, children have consistently been reported to be more susceptible to this type of injury because of their disproportionately larger head, ligament laxity, and injury mechanisms. However, to date, rates of missed injury and outcomes including neurologic recovery of pediatric and adult populations following this insult have not been comparatively evaluated.

Methods

Standard search engines were used to investigate outcomes of traumatic atlanto-occipital dislocation in children and adolescents compared to adults.

Conclusions

Based on case reports and small series from the literature, it seems that children and adolescents tend to have a better likelihood of survival with the possibility of long-term neurological complications. Comparatively, adults who suffer traumatic atlanto-occipital dislocation either succumb to their injuries or survive with very little if any neurological complications.
Literatur
1.
Zurück zum Zitat Blackwood NJ (1908) Atlanto-occipital dislocation. A case of fracture of the atlas and axis and forward dislocation of the occiput on the spinal column, life being maintained for thirty-four hours and forty minutes by artificial respiration during which a laminectomy was performed upon the third cervical vertebra. Ann Surg 47:654–658CrossRefPubMedPubMedCentral Blackwood NJ (1908) Atlanto-occipital dislocation. A case of fracture of the atlas and axis and forward dislocation of the occiput on the spinal column, life being maintained for thirty-four hours and forty minutes by artificial respiration during which a laminectomy was performed upon the third cervical vertebra. Ann Surg 47:654–658CrossRefPubMedPubMedCentral
2.
Zurück zum Zitat Hall G, Kinsman M, Nazar R, Hruska T, et al. (2015) Atlanto-occipital dislocation. World J Orthod 6:236–243CrossRef Hall G, Kinsman M, Nazar R, Hruska T, et al. (2015) Atlanto-occipital dislocation. World J Orthod 6:236–243CrossRef
3.
Zurück zum Zitat Martinez-Lage J, Alarcón F, Alfaro R, et al. (2013) Severe spinal cord injury in craniocervical dislocation: case based update. Childs Nerv Syst 29:187–194CrossRefPubMed Martinez-Lage J, Alarcón F, Alfaro R, et al. (2013) Severe spinal cord injury in craniocervical dislocation: case based update. Childs Nerv Syst 29:187–194CrossRefPubMed
4.
Zurück zum Zitat Jeszenszky D, Fekete T, Lattig F, Bognár L (2010) Intraarticular atlantooccipital fusion for the treatment of traumatic occipitocervical dislocation in a child. Spine 35:E421–E426CrossRefPubMed Jeszenszky D, Fekete T, Lattig F, Bognár L (2010) Intraarticular atlantooccipital fusion for the treatment of traumatic occipitocervical dislocation in a child. Spine 35:E421–E426CrossRefPubMed
5.
Zurück zum Zitat Horn E, Feiz-Erfan I, Lekovic G, et al. (2007) Survivors of occipitoatlantal dislocation injuries: imaging and clinical correlates. J Neurosurg Spine 6:113–120CrossRefPubMed Horn E, Feiz-Erfan I, Lekovic G, et al. (2007) Survivors of occipitoatlantal dislocation injuries: imaging and clinical correlates. J Neurosurg Spine 6:113–120CrossRefPubMed
6.
Zurück zum Zitat McElwee K, Wargo C (2006) Traumatic atlanto-occipital dislocation: a pediatric case report. J Transcult Nurs 13:186–189 McElwee K, Wargo C (2006) Traumatic atlanto-occipital dislocation: a pediatric case report. J Transcult Nurs 13:186–189
7.
Zurück zum Zitat Hosalkar H, Cain E, Horn D, et al. (2005) Traumatic atlanto-occipital dislocation in children. J Bone Joint Surg 87:2480–2488CrossRefPubMed Hosalkar H, Cain E, Horn D, et al. (2005) Traumatic atlanto-occipital dislocation in children. J Bone Joint Surg 87:2480–2488CrossRefPubMed
8.
Zurück zum Zitat Houle P, McDonnell D, Vender J (2001) Traumatic atlanto-occipital dislocation in children. Pediatr Neurosurg 34:193–197CrossRefPubMed Houle P, McDonnell D, Vender J (2001) Traumatic atlanto-occipital dislocation in children. Pediatr Neurosurg 34:193–197CrossRefPubMed
9.
Zurück zum Zitat Astur N, Klimo P Jr, Sawyer J, et al. (2013) Traumatic atlanto-occipital dislocation in children: evaluation, treatment and outcomes. J Bone Joint Surg 95(e194):1–8 Astur N, Klimo P Jr, Sawyer J, et al. (2013) Traumatic atlanto-occipital dislocation in children: evaluation, treatment and outcomes. J Bone Joint Surg 95(e194):1–8
10.
Zurück zum Zitat Astur N, Sawyer J, Klimo P Jr, et al. (2014) Traumatic atlanto-occipital dislocation in children. J Am Acad Orthop Surg 22:274–282CrossRefPubMed Astur N, Sawyer J, Klimo P Jr, et al. (2014) Traumatic atlanto-occipital dislocation in children. J Am Acad Orthop Surg 22:274–282CrossRefPubMed
11.
Zurück zum Zitat Steinmetz M, Lechner R, Anderson J (2003) Atlantooccipital dislocation in children: presentation, diagnosis, and management. Neurosurg Focus 14:1–7CrossRef Steinmetz M, Lechner R, Anderson J (2003) Atlantooccipital dislocation in children: presentation, diagnosis, and management. Neurosurg Focus 14:1–7CrossRef
12.
Zurück zum Zitat Kriss V (1999) Down syndrome: imaging of multiorgan involvement. Clin Pediatr 38:441–449CrossRef Kriss V (1999) Down syndrome: imaging of multiorgan involvement. Clin Pediatr 38:441–449CrossRef
13.
Zurück zum Zitat Dimaio D, DiMaio V (2001) Forensic pathology. CRC Press, Boca Raton, pp. 179–181 Dimaio D, DiMaio V (2001) Forensic pathology. CRC Press, Boca Raton, pp. 179–181
14.
Zurück zum Zitat Avellino AM, Mann FA, Grady MS, Chapman JR, Ellenbogen RG, Alden TD, Mirza SK (2005) The misdiagnosis of acute cervical spine injuries and fractures in infants and children: the 12-year experience of a level I pediatric and adult trauma center. Childs Nerv Syst 21(2):122–127CrossRefPubMed Avellino AM, Mann FA, Grady MS, Chapman JR, Ellenbogen RG, Alden TD, Mirza SK (2005) The misdiagnosis of acute cervical spine injuries and fractures in infants and children: the 12-year experience of a level I pediatric and adult trauma center. Childs Nerv Syst 21(2):122–127CrossRefPubMed
15.
Zurück zum Zitat Ghatan S, Newell DW, Grady MS, Mirza SK, Chapman JR, Mann FA, Ellenbogen RG (2004) Severe posttraumatic craniocervical instability in the very young patient. Report of three cases. J Neurosurg 101(1 Suppl):102–107PubMed Ghatan S, Newell DW, Grady MS, Mirza SK, Chapman JR, Mann FA, Ellenbogen RG (2004) Severe posttraumatic craniocervical instability in the very young patient. Report of three cases. J Neurosurg 101(1 Suppl):102–107PubMed
16.
Zurück zum Zitat Bellabarba C, Mirza SK, West GA, Mann FA, Dailey AT, Newell DW, Chapman JR (2006) Diagnosis and treatment of craniocervical dislocation in a series of 17 consecutive survivors during an 8-year period. J Neurosurg Spine 4(6):429–440CrossRefPubMed Bellabarba C, Mirza SK, West GA, Mann FA, Dailey AT, Newell DW, Chapman JR (2006) Diagnosis and treatment of craniocervical dislocation in a series of 17 consecutive survivors during an 8-year period. J Neurosurg Spine 4(6):429–440CrossRefPubMed
17.
Zurück zum Zitat Vaccaro A, Fehlings M, Dvorak M (2011) Essentials of spinal cord injury: basic research to clinical practice. Thieme Medeical Publishers, Inc, New York Vaccaro A, Fehlings M, Dvorak M (2011) Essentials of spinal cord injury: basic research to clinical practice. Thieme Medeical Publishers, Inc, New York
18.
Zurück zum Zitat Eck J, DiPaola C (2014) Essentials of spinal disorders. JP Medical LTD, London, pp. 70–71 Eck J, DiPaola C (2014) Essentials of spinal disorders. JP Medical LTD, London, pp. 70–71
19.
Zurück zum Zitat Reed C, Campbell S, Beall D, Bui J, Stefko R (2005) Atlanto-occipital dislocation with traumatic pseudomeningocele formation and post-traumatic syringomyelia. Spine 30:E128–E133CrossRefPubMed Reed C, Campbell S, Beall D, Bui J, Stefko R (2005) Atlanto-occipital dislocation with traumatic pseudomeningocele formation and post-traumatic syringomyelia. Spine 30:E128–E133CrossRefPubMed
20.
Zurück zum Zitat Carvalho M, Swash M (2014) Neurologic complications of craniovertebral dislocation. Handb Clin Neurol 119:435–448CrossRefPubMed Carvalho M, Swash M (2014) Neurologic complications of craniovertebral dislocation. Handb Clin Neurol 119:435–448CrossRefPubMed
21.
Zurück zum Zitat Aoyama M, Yasuda M, Joko M, Takeuchi M, Niwa A, Takayasu M (2015) Pitfalls in the management of atlanto-occipital dislocation. Asian Spine J 9:465–470CrossRefPubMedPubMedCentral Aoyama M, Yasuda M, Joko M, Takeuchi M, Niwa A, Takayasu M (2015) Pitfalls in the management of atlanto-occipital dislocation. Asian Spine J 9:465–470CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Bransford R, Alton T, Patel A, Bellabarba C (2014) Upper cervical spine trauma. J Am Acad Orthop Surg 22:718–729CrossRefPubMed Bransford R, Alton T, Patel A, Bellabarba C (2014) Upper cervical spine trauma. J Am Acad Orthop Surg 22:718–729CrossRefPubMed
23.
Zurück zum Zitat Sun P, Poffenbarger G, Durham S, Zimmerman R (2000) Spectrum of occipitoatlantoaxial injury in young children. J Neurosurg Spine 93:28–39CrossRef Sun P, Poffenbarger G, Durham S, Zimmerman R (2000) Spectrum of occipitoatlantoaxial injury in young children. J Neurosurg Spine 93:28–39CrossRef
24.
Zurück zum Zitat Donahue D, Muhlbauer M, Kaufman R, Warner W, Sanford R (1994) Childhood survival of atlantooccipital dislocation: underdiagnosis, recognition, treatment and review of the literature. Pediatr Neurosurg 21:105–111CrossRefPubMed Donahue D, Muhlbauer M, Kaufman R, Warner W, Sanford R (1994) Childhood survival of atlantooccipital dislocation: underdiagnosis, recognition, treatment and review of the literature. Pediatr Neurosurg 21:105–111CrossRefPubMed
25.
Zurück zum Zitat Pang D (2012) Treating atlantooccipital dislocation in very young children and infants: solving the Archimedean spiral. World Neurosurg 78:614–616CrossRefPubMed Pang D (2012) Treating atlantooccipital dislocation in very young children and infants: solving the Archimedean spiral. World Neurosurg 78:614–616CrossRefPubMed
26.
Zurück zum Zitat Joaquim A, Ghizoni E, Tedeschi H, Lawrence B, et al. (2014) Upper cervical injuries—a rational approach to guide surgical management. J Spinal Cord Med 37:139–151CrossRefPubMedPubMedCentral Joaquim A, Ghizoni E, Tedeschi H, Lawrence B, et al. (2014) Upper cervical injuries—a rational approach to guide surgical management. J Spinal Cord Med 37:139–151CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Singh B, Cree A (2015) Laminar screw fixation of the axis in the pediatric population: a series of eight patients. Spine J 15:E17–E25CrossRefPubMed Singh B, Cree A (2015) Laminar screw fixation of the axis in the pediatric population: a series of eight patients. Spine J 15:E17–E25CrossRefPubMed
28.
Zurück zum Zitat Gire J, Roberto R, Bobinski M, Klineberg E, Durbin-Johnson B (2013) The utility and accuracy of computed tomography in the diagnosis of occipitocervical dissocation. The Spine J 13:510–519CrossRefPubMed Gire J, Roberto R, Bobinski M, Klineberg E, Durbin-Johnson B (2013) The utility and accuracy of computed tomography in the diagnosis of occipitocervical dissocation. The Spine J 13:510–519CrossRefPubMed
29.
Zurück zum Zitat Ben-Galim P, Sibai T, Hipp J, Heggeness M, Reitman C (2008) Internal decapitation: survival after head to neck dissociation injuries. Spine 33:1774–1749CrossRef Ben-Galim P, Sibai T, Hipp J, Heggeness M, Reitman C (2008) Internal decapitation: survival after head to neck dissociation injuries. Spine 33:1774–1749CrossRef
30.
Zurück zum Zitat Ehlinger M, Charles Y, Adam P, et al. (2011) Survivor of a traumatic atlanto-occipital dislocation. J Orthop Trauma 97:335–340 Ehlinger M, Charles Y, Adam P, et al. (2011) Survivor of a traumatic atlanto-occipital dislocation. J Orthop Trauma 97:335–340
31.
Zurück zum Zitat Grabb B, Frye T, Hedlund G, et al. (1999) MRI diagnosis of suspected atlanto-occipital dissociation in childhood. Pediatr Radiol 29:275–281CrossRefPubMed Grabb B, Frye T, Hedlund G, et al. (1999) MRI diagnosis of suspected atlanto-occipital dissociation in childhood. Pediatr Radiol 29:275–281CrossRefPubMed
32.
Zurück zum Zitat Kaufman R, Dunbar J, Botsford J, McLaurin R (1982) Traumatic longitudinal atlanto-occipital distraction injuries in children. AJNR Am J Neuroradiol 3:415–419PubMed Kaufman R, Dunbar J, Botsford J, McLaurin R (1982) Traumatic longitudinal atlanto-occipital distraction injuries in children. AJNR Am J Neuroradiol 3:415–419PubMed
33.
Zurück zum Zitat Kalani M, Ratliff J (2013) Considering the diagnosis of occipitocervical dissociation. Spine J 13:520–522CrossRefPubMed Kalani M, Ratliff J (2013) Considering the diagnosis of occipitocervical dissociation. Spine J 13:520–522CrossRefPubMed
Metadaten
Titel
Traumatic atlanto-occipital dislocation: do children and adolescents have better or worse outcomes than adults? A narrative review
verfasst von
R. Shane Tubbs
Chirag Patel
Marios Loukas
Rod J. Oskouian
Jens R. Chapman
Publikationsdatum
25.05.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Child's Nervous System / Ausgabe 8/2016
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-016-3118-y

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