Abstract
Background Data: atlantoaxial rotatory fixation (AARF) although rare, is a wellknown condition to most spinal surgeons. Occipitoatlantoaxial rotatory fixation (COAARF) is a condition that may develop as a compensatory event following AARFmaking diagnosis more difficult. Most cases of COAARF present late making their management a difficult task.Purpose: to demonstrate a neglected case of COAARF Study Design: case report Patients and Methods: we report a 9 years old girl with neglected COAARF following minor trauma. 7 months after trauma we could not reduce its rotation operatively. Results: delayed diagnosis of COAARF precluded its reduction Conclusion: COAARF can result from relatively minor trauma and should be suspected in children with persisting neck pain and decreased neck movements.Early diagnosis of COAARF is important and facilitates its management. MS and 3D CT-scan is the corner stone in its diagnosis. (2013ESJ053)
Highlights
Atlantoaxial rotatory fixation (AARF) rare, is a wellknown condition to most spinal surgeons
COAARF is a condition that may develop as a compensatory event following atlantoaxial rotatory fixation (AARF).[11,17]
In this study we reported a case of COAARF after minor trauma and discuss the problem of diagnosis and management of such cases
Summary
Atlantoaxial rotatory fixation (AARF) rare, is a wellknown condition to most spinal surgeons. She suffered severe neck pain with typical cock robin posture At that time she was neurologically intact and had limited painful neck movement. Her plain radiograph was assessed as normal by a non-specialist and she was managed by antiinflammatory drugs and cervical collar. After that operative reduction was undertaken through bilateral lateral cervical approach to undo fusion between lateral mass of the upper cervical spine, which proved ineffective intraoperatively She was left for monitored traction for another week without response. She was managed with Philadelphia collar for further 3 month after that her pain was completely relived and her neck position was near normal, with some acceptable limitation of neck movement
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