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  • Title: Odontoid fracture and C1-C2 subluxation in psoriatic cervical spondyloarthropathy. A case report.
    Author: Sosner J, Fast A, Kahan BS.
    Journal: Spine (Phila Pa 1976); 1996 Feb 15; 21(4):519-21. PubMed ID: 8658259.
    Abstract:
    STUDY DESIGN: Case presentation and review of pertinent literature. OBJECTIVES: To present an unusual case and alert other physicians to possible missed diagnoses. SUMMARY OF BACKGROUND DATA: An unusual case is presented of a young man with server psoriatic spondyloarthropathy and fusion of C2-C7 (Type II cervical psoriatic ankylosing disease) who fell at home, sustaining an unrecognized fracture of the odontoid process leading to subluxation of C1-C2 and the transitory tetraplegia. The patient presented with torticollis, and the fracture was unrecognized for a long period of time. METHODS: Case presentation. RESULTS: This patient became independent in all activities of daily living after surgery and rehabilitation despite persistence of torticollis. CONCLUSIONS: A patient who presents clinically with traumatic torticollis after minor trauma and who also has psoriasis and ankylosis of the cervical spine should be suspected of having a fracture-subluxation until definitely proven otherwise. In the present case, the late diagnosis delayed surgical stabilization.
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