A comprehensive analysis of traumatic atlanto-occipital and atlanto-axial dislocations: A case series from a level one trauma center
Year: 2025
Type: article
Study design: Observational Study
Abstract: IntroductionTraumatic atlanto-occipital dislocations (AOD) and atlanto-axial dislocations (AAD) are catastrophic injuries of the craniovertebral junction associated with high mortality and significant long-term morbidity for survivors. Although these injuries are uncommon, their outcomes are often poor due to severe neurological damage and challenges in diagnosis and management. This study aims to provide a comprehensive analysis of AOD and AAD cases seen at a level one trauma center in the Southwestern United States, specifically in regard to injury characteristics, management strategies, and patient outcomes.MethodsA retrospective review was conducted on patients with traumatic AOD and AAD who were admitted to a single level one trauma center between January 1, 2018, and November 14, 2023. Data collected included patient demographics, mechanisms of injury, clinical course, and post-injury outcomes. Patients were categorized into dislocation and subluxation groups. Statistical analyses were performed using Chi-square tests for categorical variables and t-tests for continuous variables to assess differences in outcomes between the groups.ResultsThe cohort included 8 patients with dislocations and 13 with subluxations, with a mean age of 39.25 years. Motor vehicle collisions were the predominant mechanism of injury (42.86%). Patients with dislocations had significantly higher mortality rates (75%) compared to those with subluxations (23.08%, p=0.0195). Dislocation patients also had higher rates of concurrent traumatic brain injury (87.5% vs. 30.77%, p=0.024) and cardiorespiratory arrest (75% vs. 15.38%, p=0.0014). Patients that survived their injuries often required long-term care, with 0 of the dislocation patients being discharged home post-hospitalization.DiscussionThis study emphasizes the severe outcomes associated with AOD and AAD traumatic injuries. Despite advances in management techniques, these injuries remain highly lethal and result in significant long-term disabilities for surviving individuals. Our findings emphasize the need for improved diagnostic protocols and early intervention strategies. Future research should focus on multicenter studies to validate current literature and explore new therapeutic approaches to ultimately improve patient outcomes.
Source: Trauma Case Reports
Institution: University of Nevada, Las Vegas
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,190
OpenAlex ID: W4414805250