Unrecognized C1 Lateral Mass Fracture Without Instability; The Origin of Posterior Neck Pain
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Posterior neck pain is a common complaint of patients in the pain clinic. The atlas (C1) burst fracture is known to be a cause of posterior neck pain and instability. Although the atlas burst fracture and instability can be discovered by plain X-rays which show lateral mass displacement or widening of the atlantodental interval, assessment of an atlas burst fracture can be difficult if there is no instability in the imaging study. Here we report a case of a 46-year-old female patient who had complained of sustained posterior neck pain for 6 months. Plain X-rays showed only disc space narrowing at C4/5 and C5/6, without any cervical instability. However, an unrecognized C1 lateral mass fracture was detected by CT and MRI. The patient’s pain was then successfully treated after atlantoaxial joint injection with a C2 DRG block.
Abstract
Posterior neck pain is a common complaint of patients in the pain clinic. The atlas (C1) burst fracture is known to be a cause of posterior neck pain and instability. Although the atlas burst fracture and instability can be discovered by plain X-rays which show lateral mass displacement or widening of the atlantodental interval, assessment of an atlas burst fracture can be difficult if there is no instability in the imaging study. Here we report a case of a 46-year-old female patient who had complained of sustained posterior neck pain for 6 months. Plain X-rays showed only disc space narrowing at C4/5 and C5/6, without any cervical instability. However, an unrecognized C1 lateral mass fracture was detected by CT and MRI. The patient’s pain was then successfully treated after atlantoaxial joint injection with a C2 DRG block.
참고문헌 (8)
- Kakarla UK, "Atlas fractures", Neurosurgery, 66, pp.60~67 (2010)
- Dickman CA, "Magnetic resonance imaging of the transverse atlantal ligament for the evaluation of atlantoaxial instability", J Neurosurg, 75, pp.221~227 (1991)
- Spence KF Jr, "Bursting atlantal fracture associated with rupture of the transverse ligament", J Bone Joint Surg Am, 52, pp.543~549 (1970)
- Sherk HH, "Fractures of the atlas", J Bone Joint Surg Am, 52, pp.1017~1024 (1970)
- Landells CD, "Fractures of the atlas: classification, treatment and morbidity", Spine, 13, pp.450~452 (1988)
- Fielding JW, "Tears of the transverse ligament of the atlas. A clinical and biomechanical study", J Bone Joint Surg Am, 56, pp.1683~1691 (1974)
- Dickman CA, "Injuries involving the transverse atlantal ligament: classification and treatment guidelines based upon experience with 39 injuries", Neurosurgery, 38, pp.44~50 (1996)
- Kesterson L, "Evaluation and treatment of atlas burst fractures (Jefferson fractures)", J Neurosurg, 75, pp.213~220 (1991)
