Spontaneous atlantoaxial rotatory fixation in old age after cerebral infarction: case report
Mori, K.; Hukuda, S.; Katsuura, A.; Saruhashi, Y.; Asajima, S.
Spine 25(16): 2137-2140
2000
ISSN/ISBN: 0362-2436 PMID: 10954647 Document Number: 514341
Study Design: Case report of spontaneous Fielding and Hawkins Type I atlantoaxial rotatory fixation in a 78-year-old man after hemiplegia and homonymous hemianopsia caused by cerebral infarction. Objectives: To described a case of spontaneous atlantoaxial rotatory fixation in old age and review previous adult cases of atlantoaxial rotatory fixation without fracture. Summary of Background Data: Atlantoaxial rotatory fixation in adults is a relatively rare finding and is mainly caused by trauma. To the author's knowledge, there has been no previous report of spontaneous atlantoaxial rotatory fixation in old age. Methods: The patient's head was fixed in a 40degree left-rotated position. Left hemiplegia and homonymous left-side hemianopsia developed due to cerebral infarction. Computed tomography of the cervical spine clearly showed rotatory fixation of the atlas on the axis. Results: Successful reduction was obtained after 1 day of skull traction. Conclusions: It was hypothesized that repeated left-rotational stress due to homonymous hemianopsia loaded to the atlantoaxial joint caused abnormal laxity of the joint.