What should I do if I have cervical atlantoaxial dislocation?

The cervical atlantoaxial joint is one of the most important parts of the cervical spine. If the cervical atlantoaxial joint is dislocated, it will affect many people's normal movement and physiological activities. In severe cases, it may endanger many people's lives. Therefore, we must actively treat it. Many people may equate atlantoaxial joint dislocation with cervical spondylosis. In fact, there is a big difference between the two. So, what should we do if cervical atlantoaxial dislocation occurs?

1. Cause

The stability of the atlantoaxial joint mainly depends on the following structures: the anterior arch of the atlas, the transverse ligament and the odontoid process of the axis; and the lateral mass joints between the atlas and the axis. If the integrity of the above structures is destroyed or they are misused for some reason, it may cause instability or dislocation of the atlantoaxial joint. There are many causes of the disease, such as old odontoid fractures caused by trauma, congenital malformations of the odontoid, infection or inflammation that damages the transverse ligament or lateral mass joint, and even tuberculosis or tumors invading the atlantoaxial joint, all of which can cause atlantoaxial instability or dislocation. The most common clinical causes are trauma and congenital malformations.

2. Clinical manifestations

(1) Symptoms of cervical radiculopathy

There are neck pain, limited and stiff neck movement, especially limited rotation of the head and neck, pain in the occipital area, etc.; such as weakness in the limbs, unsteady walking, inflexible hands, abnormal bowel movements, etc.; also includes numbness, tingling and even burning sensation in the trunk and limbs.

(2) Respiratory dysfunction

Due to compression of the medullary spinal cord junction, respiratory dysfunction occurs; severe patients have labored breathing even at rest, or have a calm breathing rate of >30 times, and have a weak cough and labored sputum expectoration; terminally ill patients experience respiratory failure and even death.

(3) Other symptoms

In addition, if combined with basilar indentation, cerebellar tonsillar herniation or syringomyelia, affecting the medulla oblongata and brain stem, lower cranial nerve symptoms such as dysphagia, dysarthria (slurred speech), blurred vision, vertigo, tinnitus, etc. may also occur. 3. Treatment (1) Atlantoaxial dislocation should be treated surgically as soon as possible

For cases of severe swan neck deformity, a combined anterior and posterior approach surgery is required.

(2) Atlantoaxial joint release via the oropharyngeal approach

Using orthopedics to correct the alignment of the upper cervical vertebrae and thus completely relieve the compression of the spinal cord is a new concept in the treatment of atlantoaxial dislocation. This new treatment concept is more reasonable than the traditional osteotomy to relieve the compressed area.

(3) After release and reduction, posterior fixation and bone grafting are performed [5

In 1987, Magerl first applied pedicle screw technology to the upper cervical spine. He used two screws from the posterior approach through the axis vertebral arch isthmus (root) into the lateral mass of the atlas. This fixation method once became a classic procedure for atlantoaxial joint stabilization due to its stability.