{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T23:50:38Z","timestamp":1725493838832},"reference-count":5,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:p>The authors report an unusual case of an odontoid synchondrosis fracture causing chronic translational anterior atlanto-axial subluxation and present a discussion of the unique management of this case. Traumatic translational anterior atlanto-axial subluxation is a rare manifestation within pediatrics. Patients with preexisting abnormalities in ligamentous or bony structures may present with unusual symptomatology, which could result in delay of treatment. A 6-year-old male patient with autism who presented with acute respiratory arrest was noted to have an odontoid synchondrosis fracture and severe anterior translational atlanto-axial subluxation. Initial attempts at reduction with halo traction were tried for first-line treatment. However, because of concern regarding possible inadvertent worsening of the impingement, the presence of comorbid macrocephaly, and possible instability with only C1\u20132 fusion, a posterior C1 laminectomy was performed. Further release of the C1\u20132 complex and odontoid peg from extensive fibrous tissue allowed for complete reduction. Acute injuries of the C1\u20132 complex may not present as expected, and the presence of pain is not a reliable symptom. Halo traction is an appropriate initial treatment, but some patients may require surgical realignment and stabilization.<\/jats:p>","DOI":"10.3171\/2019.8.peds18517","type":"journal-article","created":{"date-parts":[[2020,2,7]],"date-time":"2020-02-07T22:01:25Z","timestamp":1581112885000},"page":"192-195","source":"Crossref","is-referenced-by-count":1,"title":["Management of an odontoid synchondrosis fracture causing chronic translational anterior atlanto-axial subluxation in a child with autism: case report"],"prefix":"10.3171","volume":"25","author":[{"given":"William","family":"Fuell","sequence":"first","affiliation":[{"name":"Division of Neurosurgery, Arkansas Children\u2019s Hospital;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucas","family":"Bradley","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Arkansas Children\u2019s Hospital;"},{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gresham T.","family":"Richter","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Arkansas Children\u2019s Hospital and University of Arkansas for Medical Sciences; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noojan","family":"Kazemi","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory","family":"Albert","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Arkansas Children\u2019s Hospital;"},{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"McCarthy","sequence":"additional","affiliation":[{"name":"Neurological Surgery\u2013Spine Division, University of Arkansas for Medical Sciences, Little Rock, Arkansas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eylem","family":"Ocal","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Arkansas Children\u2019s Hospital;"},{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Injury","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1016\/0020-1383(95)00006-U","article-title":"Delayed diagnosis of an odontoid process fracture in an infant","volume":"26","author":"Clasper JC","year":"1995","unstructured":"Clasper JC, Pailthorpe CA: Delayed diagnosis of an odontoid process fracture in an infant. 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Pediatr Radiol 45:872\u2013881, 20152542521010.1007\/s00247-014-3224-5"},{"key":"b5","series-title":"Global Spine J","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1055\/s-0034-1376371","article-title":"A review of the diagnosis and treatment of atlantoaxial dislocations","volume":"4","author":"Yang SY","year":"2014","unstructured":"Yang SY, Boniello AJ, Poorman CE, Chang AL, Wang S, Passias PG: A review of the diagnosis and treatment of atlantoaxial dislocations. 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