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  • Title: Traumatic Atlanto-Occipital Dissociation and Atlantoaxial Instability: Concomitant Ligamentous Injuries without Neurologic Deficit: A Case Report.
    Author: Tobert DG, Ferrone ML, Czuczman GJ.
    Journal: JBJS Case Connect; 2018; 8(3):e62. PubMed ID: 30095471.
    Abstract:
    CASE: A 35-year-old man was involved in a motor-vehicle collision and sustained multiple thoracoabdominal and extremity injuries. A high injury burden and a normal neurologic examination contributed to a delay in diagnosing a ligamentous, combined atlanto-occipital dissociation (AOD) and vertical atlantoaxial injury (AAI). Additional imaging revealed the combined injury, and the patient underwent an occipitocervical fusion. CONCLUSION: To our knowledge, this is the first case of a simultaneous traumatic AOD and AAI without fracture in a neurologically intact patient. Knowledge of reliable and easily applied radiographic relationships is important to expeditiously diagnose potentially lethal yet easily overlooked occipitocervical injuries.
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