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논문 기본 정보

자료유형
학술저널
저자정보
Umebayashi, Daisuke (Department of Neurosurgery, Nagoya University School of Medicine) Hara, Masahito (Department of Neurosurgery, Nagoya University School of Medicine) Nishimura, Yusuke (Department of Neurosurgery, Nagoya University School of Medicine) Wakabayashi, Toshihiko (Department of Neurosurgery, Nagoya University School of Medicine)
저널정보
대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제55권 제5호
발행연도
2014.1
수록면
284 - 288 (5page)

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A rare case of atlantoaxial rotatory subluxation occurred after pediatric cervical spine surgery performed to remove a dumbbell-shaped meningioma at the level of the C1/C2 vertebrae. This case is classified as a post-surgical atlantoaxial rotatory subluxation, but has a very rare morphology that has not previously been reported. Although there are several reports about post-surgical atlantoaxial rotatory subluxation, an important point of this case is that it might be directly related to the spinal cord surgery in C1/C2 level. On day 6 after surgery, the patient presented with the Cock Robin position, and a computed tomography scan revealed a normal type of atlantoaxial rotatory subluxation. Manual reduction was performed followed by external fixation with a neck collar. About 7 months after the first surgery, the subluxation became severe, irreducible, and assumed an atypical form where the anterior tubercle of C1 migrated to a cranial position, and the posterior tubercle of C1 and the occipital bone leaned in a caudal direction. The pathogenic process suggested deformity of the occipital condyle and bilateral C2 superior facets with atlantooccipital subluxation. A second operation for reduction and fixation was performed, and the subluxation was stabilized by posterior fixation. We encountered an unusual case of a refractory subluxation that was associated with an atypical deformity of the upper spine. The case was successfully managed by posterior fixation.

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