The Surgical Treatment for Occipito-atlantoaxial Rotatory Fixation: a Case Report

Abstract

A 10-year-old boy complaining of neck pain without any inducement was referred to our hospital. Images at the first visit showed an atlantoaxial rotatory fixation (AARF). He received conservative treatment for 14 months with a cervical collar, Glisson traction and halo vest fixation after manual reduction under general anesthesia. However, residual rotational position and cervical pain recurred. Finally, he required surgical intervention with posterior C1-2 fixation. An atlantoaxial rotation with O-C1 joint lesion (OAARF) may result in worse treatment outcome as conservative treatment compared to AARF. It is necessary to evaluate the pathological condition at an early stage of OAARF and consider decision making including the surgical treatment.