Traumatic atlanto-occipital dislocation: do children and adolescents have better or worse outcomes than adults? A narrative review

Childs Nerv Syst. 2016 Aug;32(8):1387-92. doi: 10.1007/s00381-016-3118-y. Epub 2016 May 25.

Abstract

Background: Traumatic atlanto-occipital dislocation is an uncommon, severely unstable pathology, which can lead to detrimental or even fatal neurological impairment. Specifically, children have consistently been reported to be more susceptible to this type of injury because of their disproportionately larger head, ligament laxity, and injury mechanisms. However, to date, rates of missed injury and outcomes including neurologic recovery of pediatric and adult populations following this insult have not been comparatively evaluated.

Methods: Standard search engines were used to investigate outcomes of traumatic atlanto-occipital dislocation in children and adolescents compared to adults.

Conclusions: Based on case reports and small series from the literature, it seems that children and adolescents tend to have a better likelihood of survival with the possibility of long-term neurological complications. Comparatively, adults who suffer traumatic atlanto-occipital dislocation either succumb to their injuries or survive with very little if any neurological complications.

Keywords: Dislocation; Internal decapitation; Spinal cord injury; Trauma.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Atlanto-Occipital Joint / injuries*
  • Atlanto-Occipital Joint / pathology*
  • Child
  • Humans
  • Joint Dislocations / complications
  • Joint Dislocations / diagnosis*
  • Nervous System Diseases / etiology