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Rehabilitation Practice and Science

Translated Title

寰樞椎半脫位或脫位之研究

Abstract

Neck pain and neck stiffness are among the commonest clinical complaints resulting from atlantoaxial subluxation and dislocation and also most easily lead to misdiagnosis and inadequate management. We defined the clinical characteristics of atlantoaxial subluxation and/or dislocation in 25 patients hospitalized from Jan 1987 to Aug 1989, who were studied retrospectively. The commonest symptoms were found to be neck stiffness, followed by numbness of limbs, neck pain and motor weakness in decreasing frequency. The commonest physical findings were limitation of neck motion, followed by decrease of muscle power, sensory impairment and hyperreflexia in decreasing frequency. Traffic accident was the commonest cause of lesions, followed by falling down and rheumatoid arthritis. Six patients had been misdiagnosed and 4 patients had received inadequate treatments before. The best result was achieved in patients treated by operation. We concluded that detailed history of trauma or inflammatory disease and complete physical examination are important for the diagnosis of atlantoaxial subluxation and/or dislocation. Dynamic view of C-spine and open mouth view should be taken on suspicion of atlantoaxial subluxation and/or dislocation in order to avoid misdiagnosis or inadequate management. Early diagnosis and proper surgical intervention usually lead to better prognosis, otherwise severe neurological deficits might ensure.

Language

Traditional Chinese

First Page

121

Last Page

129

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