Object

Traumatic atlanto-occipital dislocation (AOD) is a relatively uncommon traumatic cervical spine injury characterized by disruption and instability of the atlanto-occipital joint. At many centers, management of pediatric AOD includes occipitocervical arthrodesis, but whether external immobilization without surgery is a viable treatment option for some pediatric patients is unknown. To answer this question, we analyzed our outcomes of pediatric AOD at the Hospital for Sick Children.

Methods

We performed a retrospective chart review of all children with clinical and radiographic evidence of traumatic AOD. A total of 10 patients met criteria for traumatic AOD: 8 were treated with external immobilization alone and 2 were treated with occipitocervical arthrodesis.

Results

Eight patients were treated exclusively with 3 months of halo immobilization. Two patients were treated with occipitocervical instrumentation and arthrodesis. No patient undergoing halo immobilization required subsequent operative fusion.

Conclusion

Halo immobilization is a safe, viable, and definitive treatment option for the selected children with AOD.

中文翻译：

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儿童创伤性寰枕关节脱位：可以选择外部固定吗？

目的

创伤性寰枕关节脱位（AOD）是一种相对罕见的外伤性颈椎损伤，其特征是寰枕关节的破裂和不稳定。在许多中心，儿科AOD的管理都包括枕颈关节固定术，但是对于某些儿科患者，未经手术的外部固定是否可行？为了回答这个问题，我们分析了病童医院的儿科AOD结果。

方法

我们对所有有创伤性AOD临床和影像学证据的儿童进行了回顾性图表审查。共有10例患者符合创伤性AOD的标准：8例仅接受外固定治疗，2例经枕颈关节固定术治疗。

结果

八名患者仅接受了3个月的光环固定治疗。两名患者接受了枕颈器械和关节固定术的治疗。无需进行光晕固定的患者无需进行后续手术融合。

结论

对于选定的AOD儿童，固定晕轮术是一种安全，可行且确定的治疗方法。