Traumatic atlanto-occipital dislocation in children

Paul Houle, Dennis E. McDonnell, John Vender

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Traumatic atlanto-occipital dislocation is seen in approximately 25% of fatal pediatric trauma. This was previously considered to be a rare and fatal entity, however with improvements in resuscitation in the field, many patients who previously might have died are now evaluated in the hospital. Treatment of atlanto-occipital instability is internal fixation. Many authors have advocated supplemental external immobilization with a halo vest. However, there are several circumstances where the application of a halo vest is undesirable. Thus a method of internal fixation and fusion that is rigid enough not to require supplemental external orthosis is necessary. We present 2 cases of atlanto-occipital dislocation which were treated with Locksley intersegmental tie bar occipital cervical fusion. Both patients achieved solid fusion without supplemental halo bracing, and made complete neurologic recoveries. Traumatic atlanto-occipital dislocation is a potentially survivable injury that requires aggressive resuscitation in the field, a high index of suspicion and early definitive surgical stabilization.

Original languageEnglish (US)
Pages (from-to)193-197
Number of pages5
JournalPediatric Neurosurgery
Volume34
Issue number4
DOIs
StatePublished - Apr 1 2001

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Resuscitation
Orthotic Devices
Wounds and Injuries
Immobilization
Nervous System
Pediatrics
Therapeutics

Keywords

  • Atlanto-occipital dislocation
  • Cervical fusion, occipital
  • Cervical fusion, posterior

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery
  • Clinical Neurology

Cite this

Traumatic atlanto-occipital dislocation in children. / Houle, Paul; McDonnell, Dennis E.; Vender, John.

In: Pediatric Neurosurgery, Vol. 34, No. 4, 01.04.2001, p. 193-197.

Research output: Contribution to journalArticle

Houle, Paul ; McDonnell, Dennis E. ; Vender, John. / Traumatic atlanto-occipital dislocation in children. In: Pediatric Neurosurgery. 2001 ; Vol. 34, No. 4. pp. 193-197.
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