Tang RH, Yin J, Zhou ZW. Atlantoaxial dislocation with vertebral artery anomaly: A case report. World J Orthop 2025; 16(2): 104095 [DOI: 10.5312/wjo.v16.i2.104095]
Corresponding Author of This Article
Ruo-Hui Tang, Department of Orthopedic, The First People’s Hospital of Kunming, No. 1228 Beijing Road, Panlong District, Kunming 650000, Yunnan Province, China. trh030609@163.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Feb 18, 2025; 16(2): 104095 Published online Feb 18, 2025. doi: 10.5312/wjo.v16.i2.104095
Atlantoaxial dislocation with vertebral artery anomaly: A case report
Ruo-Hui Tang, Jin Yin, Zhao-Wen Zhou
Ruo-Hui Tang, Jin Yin, Zhao-Wen Zhou, Department of Orthopedic, The First People’s Hospital of Kunming, Kunming 650000, Yunnan Province, China
Co-corresponding authors: Ruo-Hui Tang and Zhao-Wen Zhou.
Author contributions: Tang RH and Zhou ZW designed the research study; Tang RH, Yin J and Zhou ZW completed the surgery; Tang RH analyzed the data and wrote the manuscript. All authors have read and approved the final manuscript.
Supported by Applied Basic Research Programs of Science and Technology Commission Foundation of Yunnan Province of China, No. 202401AY070001-158.
Informed consent statement: The informed consent form has been signed.
Conflict-of-interest statement: Conflict of interest None of the authors declare any potential conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ruo-Hui Tang, Department of Orthopedic, The First People’s Hospital of Kunming, No. 1228 Beijing Road, Panlong District, Kunming 650000, Yunnan Province, China. trh030609@163.com
Received: December 10, 2024 Revised: December 29, 2024 Accepted: January 23, 2025 Published online: February 18, 2025 Processing time: 64 Days and 16 Hours
Abstract
BACKGROUND
Surgical intervention is a critical treatment approach for symptomatic atlantoaxial dislocation. However, vertebral artery injury remains a significant challenge during such procedures. We present a case of successful treatment of atlantoaxial dislocation with concurrent vertebral artery injury using interlaminar screw technology, and review the relevant literature.
CASE SUMMARY
A 69-year-old female patient, with no history of trauma, was diagnosed with atlantoaxial dislocation based on X-ray, computed tomography (CT), and magnetic resonance imaging. Preoperative CT angiography (CTA) revealed vertebral artery developmental anomalies, and she underwent posterior cervical surgery. Postoperative follow-up showed improvement in the patient’s clinical symptoms such as unstable walking and dizziness, as well as functional scores compared to pre-surgery. Intraoperative vertebral artery injury was successfully managed, and postoperative CTA review revealed no complications related to vascular damage.
CONCLUSION
Thorough preoperative evaluation, such as CTA imaging, and the surgeon’s expertise in various spinal screw placement techniques are crucial for improving the success rate of atlantoaxial dislocation surgeries.
Core Tip: Symptomatic atlantoaxial dislocation can cause persistent spinal cord compression if not treated promptly, potentially leading to paralysis or death. Surgical intervention is currently recommended. Iatrogenic vertebral artery injury (IVAI) is a severe complication of cervical spine surgery, including atlantoaxial dislocation treatment. Vertebral artery anomalies increase the risk of IVAI during the procedure. We treated a patient with atlantoaxial dislocation complicated by vertebral artery anomalies, and the case is reported subsequently
