Traumatic Posterior Atlantoaxial Dislocation without Fracture of the Odontoid Process: A Case Report and Literature Review

Yong Kyun Kim; Jin Gyoon Park; Hyun Nyeong Jung; Ju Won Kim; Seung Jin Lee

doi:10.3348/jksr.2017.76.3.233

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Kim, Park, Jung, Kim, and Lee: Traumatic Posterior Atlantoaxial Dislocation without Fracture of the Odontoid Process: A Case Report and Literature Review

Case Report

J Korean Soc Radiol 2017;76(3):233-236.

Published online: 7 January 2017

DOI: https://doi.org/10.3348/jksr.2017.76.3.233

Traumatic Posterior Atlantoaxial Dislocation without Fracture of the Odontoid Process: A Case Report and Literature Review

Yong Kyun Kim¹, Jin Gyoon Park^1,², Hyun Nyeong Jung¹, Ju Won Kim³, Seung Jin Lee^∗,⁴

¹Department of Radiology, Chonnam National University Hospital, Gwangju, Korea

²Department of Radiology, Chonnam National University Medical School, Gwangju, Korea

³Department of Radiology, Chonnam National University Hwasun Hospital, Hwasun, Korea

⁴Department of Radiology, Chonnam National University Bitgoeul Hospital, Gwangju, Korea

^∗ Corresponding author: Seung Jin Lee, MD Department of Radiology, Chonnam National University Bitgoeul Hospital, 80 Deongnam-gil, Nam-gu, Gwangju 61748, Korea. Tel. 82-62-220-5746 Fax. 82-62-226-4380 E-mail: vet-lee@hanmail.net

Received 24 June 20162 August 2016 Accepted 14 August 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Traumatic posterior atlantoaxial dislocation without odontoid fracture is very rare. Patient prognosis depends on the neurologic symptoms or the extent of damage to the structures. In this case, a 78-year-old-male suffered a posterior atlantoaxial dislocation without odontoid fracture after a traffic accident. We report this case because an exact diagnosis and proper treatment can reduce the neurologic complica-tions in patients with posterior atlantoaxial dislocation.

Index terms:

Index terms

Atlantoaxial Dislocation, Posterior, Transverse Ligament, Multimodal Imaging

REFERENCES

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Fig. 1.

Traumatic posterior atlantoaxial dislocation without fracture of the odontoid process in a 78-year-old man. Cervical spine lateral radiography (A) shows posterior dislocation of the atlas with respect to the axis. Axial computed tomography (CT) scan (B) shows that the odontoid process is located anterior to the atlas. Sagittal CT image (C) demonstrates no evidence of odontoid fracture. T2-weighted sagittal magnetic resonance (MR) (D) and fat suppression T2-weighted sagittal MR (E) demonstrate ruptured anterior longitudinal and posterior longitudinal ligaments (arrows). Also, the apical ligament (black arrowhead) is detached from the odontoid process. T2-weighted sagit-tal (D) and coronal MR (F) images show an intact transverse ligament (white arrowheads). Fluid collection or hematoma is noted in the upper cervical prevertebral and epidural regions (asterisks on image D, E and G). There is no spinal cord signal abnormality.

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