2008 年 27 巻 1 号 p. 81-86
Survivors of traumatic atlanto-occipital dislocation (AOD) have been increasingly reported, however, survival after traumatic AOD with atlanto-axial subluxation is extremely rare in adults. The aim of this study was to describe the treatment of traumatic AOD with atlanto-axial subluxation in an adult. A 40-year-old woman was injured in a traffic accident. She developed pulmonary arrest and, after cervical spine precautions were taken, the patient was intubated in the emergency room. Diagnosis was made by lateral cervical spine radiography and helical computerized tomography (CT) . The diagnosis was traumatic AOD with atlanto-axial subluxation. Reduction of the dislocation and posterior fixation were applied in this patient. She has survived for 1, 400 days after injury with ventilatory and nutritious support. Treatment of traumatic craniocervical dislocation (CCD) consists of early ventilatory support, spinal immobilization, and subsequent posterior surgical fusion.
