Treatment of Chronic Traumatic Atlanto-Axial Rotatory Subluxation in an Adult

James J. Brennan, MD
Neil Wright, MD
James Lu, MD
Carl Lauryssen, MD (St. Louis, MO)

Traumatic atlanto–axial rotatory subluxation is a relatively uncommon injury to the cervical spine that most commonly occurs in children. This is usually managed with traction and subsequent immobilization without further sequelae. Surgical fixation is rarely required.

Occasionally the diagnosis of rotatory subluxation is missed and this will require more aggressive reduction measures (including reduction under anesthesia) and a higher likelihood for surgical intervention. Delayed rotatory subluxation in an adult has never been described in the literature.

We present the case of an adult female who presented with an undiagnosed rotatory subluxation of six months. A literature review of this uncommon problem and management of this patient will be presented.