STRANGULATION-INDUCED ATLANTOAXIAL ROTATORY SUBLUXATION TREATED WITH CLOSED REDUCTION

Cervical subluxation is a broad class of injuries in which there are degrees of misalignment of vertebral bodies in relationship to adjacent vertebra. Atlantoaxial rotatory subluxation (AARS) is a subtype of cervical subluxation resulting from exaggerated rotation of the C1–C2 complex. Inflammatory,...

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Bibliographic Details
Published in:The Journal of emergency medicine 2023-11, Vol.65 (5), p.e444-e448
Main Authors: Gehrz, Joseph A., Hudson, Arianna S., James, William F., McGuire, Morgan M.
Format: Article
Language:English
Subjects:
atlantoaxial rotatory subluxation
cervical spine injury
cervical subluxation
neck trauma
strangulation
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Summary:Cervical subluxation is a broad class of injuries in which there are degrees of misalignment of vertebral bodies in relationship to adjacent vertebra. Atlantoaxial rotatory subluxation (AARS) is a subtype of cervical subluxation resulting from exaggerated rotation of the C1–C2 complex. Inflammatory, infectious, post-surgical, and traumatic etiologies are recognized and well-described. AARS is predominantly seen in children and occurs rarely in adults. We submit the case of an otherwise healthy adult male patient presenting to the emergency department with strangulation-induced C1–C2 subluxation with a rotational component that was treated at the bedside by neurosurgery with closed reduction. Why Should an Emergency Physician Be Aware of This? Clinicians must consider a broad range of serious pathologies in a patient presenting with torticollis, especially in the setting of strangulation. Although extremely rare in adults, AARS must be considered in the differential diagnosis, as early identification increases the likelihood of successful nonoperative treatment.
ISSN:0736-4679
2352-5029
DOI:10.1016/j.jemermed.2023.04.027