A Case of Delayed Myelopathy Caused by Atlantoaxial Subluxation without Fracture. (2nd April 2013)

• Record Type: Journal Article
• Authors: Takamatsu, Ryo; Takahashi, Hiroshi; Yokoyama, Yuichiro; Terajima, Fumiaki; Inoue, Yasuhiro; Fukutake, Katsunori; Wada, Akihito
• Other Names: Gotoh M. Academic Editor.; Lyons M. K. Academic Editor.; Zheng M. H. Academic Editor.
• Is Part Of: Case reports in orthopedics. Volume 2013(2013)
• Publication Date: 2013-04-02
• Subjects: Orthopedics -- Periodicals; Orthopedics; Orthopedics; Periodicals; Electronic journals; Periodicals; 616.7
• DOI: 10.1155/2013/421087
• Languages: English
• ISSNs: 2090-6749

Abstract

Abstract : We report a case of delayed myelopathy caused by atlantoaxial subluxation without fracture. The patient was a 38-year-old male who became aware of weakness in extremities. The patient had a history of hitting his head severely while diving into a swimming pool at the age of 14 years old. At that time, cervical spine plain X-ray images showed no fracture, and the cervical pain disappeared after use of a collar for several weeks. At his first visit to our department, X-ray images showed an unstable atlantoaxial joint. After surgery, weakness of the extremities gradually improved. At 6 months after surgery, bone union was completed and the symptoms disappeared. This case shows that atlantoaxial ligament injuries are difficult to diagnose and may easily be missed. A high level of suspicion is important in such cases, since neurological compromise or deterioration may occur many years after the injury.