Successful non-operative treatment of traumatic atlanto-occipital dislocation: a case report

Keagan Gertz, Chris Cornett, Emmett Gannon

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Traumatic atlanto-occipital dislocation (AOD) is most commonly treated with cranio-cervical fusion. We present a unique case in which a partial neurological recovery was made after non-operative treatment was done for AOD. Reports of non-operative treatment of this condition are rare in the literature. Case Description: An 18-year-old male sustained a traumatic AOD and atlanto-axial dislocation. His injury was characterized by bony avulsion fractures of the occipital condyles bilaterally as well as atlanto-axial dissociation. Non-operative treatment was done because of his comorbidities, primarily his morbid obesity. He was treated in a hard cervical collar for 6 months. He showed radiographic evidence of healing after being treated non-operatively in a rigid cervical collar for 6 months. Follow up at 17 months showed a partial neurological recovery with ability to ambulate assisted with a walker. Conclusions: Successful outcomes are possible with non-operative treatment of AOD. A predominant factor contributing to this patient’s successful outcome with non-operative management was likely related to the bony avulsion fractures he had which allowed bone to bone healing and settling of the fracture with gravity assisted reduction in a collar. Non-operative treatment may be considered in patients who are too unhealthy or unstable to undergo surgical intervention, although the standard of care remains surgical cranio-cervical fusion.

Original languageEnglish (US)
Pages (from-to)472-478
Number of pages7
JournalJournal of Spine Surgery
Volume9
Issue number4
DOIs
StatePublished - 2023

Keywords

  • atlanto-occipital
  • case report
  • Cervical
  • cranio-cervical
  • trauma

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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