Actual concepts of classification, diagnosis and treatment of atlanto-occipital dislocations in adults: non-systematic literature review-Reference-Cited by-同舟云学术

Actual concepts of classification, diagnosis and treatment of atlanto-occipital dislocations in adults: non-systematic literature review

Published:2021-12-23 Issue:4 Volume:18 Page:68-80
ISSN:2313-1497
Container-title:Hirurgiâ pozvonočnika (Spine Surgery)
language:
Short-container-title:Hir. pozvonoč.

Author:

Grin Andrey Anatolyevich¹^ORCID,Lvov Ivan Sergeyevich²^ORCID,Kordonskiy Anton Yuryevich²^ORCID,Konovalov Nikolay Aleksandrovich³^ORCID,Krylov Vladimir Viktorovich⁴^ORCID

Affiliation:

1. N.V. Sklifosovsky Research Institute for Emergency Medicine; A.I. Evdokimov Moscow State University of Medicine and Dentistry 3 Bolshaya Sukcharevskaya sq., Moscow, 129090, Russia; Build. 4, 1а Kuskovskaya str., Moscow, 111398, Russia

2. N.V. Sklifosovsky Research Institute for Emergency Medicine 3 Bolshaya Sukcharevskaya sq., Moscow, 129090, Russia

3. Russian Medical Academy of Continuing Professional Education; N.N. Burdenko National Medical Research Center for Neurosurgery Build. 1, 2/1 Barrikadnaya str., Moscow, 125993, Russia; 16 4th Tverskaya-Yamskaya str., Moscow, 125047, Russia

4. A.I. Evdokimov Moscow State University of Medicine and Dentistry Build. 4, 1a Kuskovskaya str., Moscow, 111398, Russia

Abstract

Objective. To review the literature on atlanto-occipital dislocation (AOD) in adults to determine the optimal classification, diagnostic method and treatment.Material and Methods. A search was conducted in the PubMed database for the period from 1966 to 2020. The initial search revealed 564 abstracts of articles. A total of 95 studies were selected for a detailed study of the full text, of which 47 studies describing data from 130 patients were included in this review.Results. The paper describes all the available AOD classifications, and discusses their advantages and disadvantages. The clinical picture, features of the diagnosis in published observations of AOD in adults, as well as the applied treatment methods and their results are presented.Conclusion. Atlanto-occipital dislocation is one of the most severe types of injuries of the cervical spine in adults, which is accompanied by damage to the medulla oblongata and gross neurological deficit in 70 % of cases. The sensitivity of radiography for the diagnosis of AOD was 56.3 %. In 18.5 % of patients, its use led to untimely diagnosis and could cause subsequent deterioration. The CT sensitivity was 96.8 %. The most accurate method of AOD verification was to determine the atlanto-occipital interval (100 % sensitivity and specificity). The optimal method of treating victims with AOD is surgical one.

Publisher

Association of Spine Surgeons

Subject

Anesthesiology and Pain Medicine,Orthopedics and Sports Medicine,Surgery

Reference65 articles.

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