Modern diagnosis and therapy of children atlanto-axial subluxation
- VernacularTitle:关于儿童自发性寰枢关节半脱位的现代诊断和治疗探讨
- Author:
Honghai LV
- Publication Type:Journal Article
- Keywords:
atlanto-axial subluxation;
children;
diagnosis;
treatment
- From:
Orthopedic Journal of China
2006;0(06):-
- CountryChina
- Language:Chinese
-
Abstract:
[Objective] To study the diagnosis and treatment of children atlanto-axial subluxation(CAAS).[Method]The clinical and pre-and posttreatment imaginological materials of 24 CAAS were reviewed and analyzed.There were 13 males and 11 females with average age 7.8 years(range:8 months-16 years).Pre-and posttreatment mouth-open cervical anterior-posterior and lateral X-ray films were taken for all cases,cervical 3D-CT and MRI were made if needed.Lateral and rotational displacement of CAAS could reveal in mouth-open cervical anterior-posterior radiographs,while thickness of post-pharyngeal soft tissue could show in lateral X-ray films.Simple fixation with neck band and analgesic were used to treat cases with mild neck pain and torticollis less than 1 week.Mandibulooccipital belt traction and analgesic were taken for treatment of the cases with sign and symptom more than 1 week.For cases with anterior displacement,the displacement should be reduced then immobilized with head trunk cast or brace for 6 weeks.Cases with symptoms lasted for 1-3 months should be treated with halo-torse plastic vest traction.And atlanto-axial fusion should be applied for cases with symtoms lasting more than 3 months.[Result]All cases were followed-up for 8 months to 2 years with average 1 year 4 months.Post-treatment radiographs showed odentoid process of axis centrally located and a normal bilateral atlas-dens intervals,as well as CT scanning revealed normal axial anterior space.There were normal cervical motion without residual deformity and no recurrence of CAAS.[Conclusion]Mouth-open anterior-posterior radiograph is an ideal measure for early diagnosis of CAAS and CT scanning is choiceable for doubtful cases.Non-surgical treatment is main therapy for CAAS while posterior bone graft fusion of atlanto-axial joint is selective method for non-reducible cases.
