What are the guideline sources, guidelines and references for Atlanto-occipital dislocation ?
Guideline sources The following summarized guidelines for the evaluation and management of atlanto-occipital dislocation (AOD) are prepared by our editorial team based on guidelines from the American Association of Neurological Surgeons (AANS/CNS 2013). 1 2 2 3 4 Definition AOD is the loss of stability between the atlas and axis (CI-C2) that results in loss of normal articulation of the upper cervical spine to the occiput. 2 Epidemiology AOD is caused due to trauma (head injuries, type II fractures), congenital conditions (Down's syndrome, skeletal dysplasias, Goldenhar syndrome, spondyloepiphyseal dysplasia, Morquio syndrome, occipitalization of atlas), and inflammation (chronic rheumatoid arthritis). 2 Disease course The injury of ligaments between the occiput and upper cervical spine results in AOD, which causes clinical manifestations of severe neck pain, lower cranial nerve deficits, unilateral/bilateral weakness, and quadriplegia, unconsciousness, respiratory arrest, spinal nerve injury, neurogenic shock, and cerebrovascular injury. 3 Prognosis and risk of recurrence AOD is associated with a mortality of 26%. 4 https://web.pathway.md/diseases/rectSjTld3LFDm9Mu 1/2 6/23/23, 3:13 AM Atlanto-occipital dislocation Pathway Guidelines 1. Diagnostic investigations Lateral cervical radiographs: obtain a lateral cervical XR for the diagnosis of AOD. B Computed tomography: obtain CT of the craniocervical junction if there is clinical or radiographic suspicion of AOD. B 2. Therapeutic procedures Traction: avoid traction in the management of patients with AOD, as it is associated with a 10% risk of neurological deterioration. D 3. Surgical interventions Internal fixation: perform internal fixation and fusion for definitive management of AOD. B References 1. Theodore N, Aarabi B, Dhall SS et al. The diagnosis and management of traumatic atlanto-occipital dislocation injuries. Neurosurgery. 2013 Mar;72 Suppl 2 114 26. Open 2. Sun Y Yang, Anthony J Boniello, Caroline E Poorman et al. A review of the diagnosis and treatment of atlantoaxial dislocations. 2014 Aug;4 3 197 210.2014 Aug;4 3 197 210. Open 3. Graham C Hall, Michael J Kinsman, Ryan G Nazar et al. Atlanto-occipital dislocation. 2015 Mar 18;6 2 236 43.2015 Mar 18;6 2 236 43. Open 4. Stephen K Mendenhall, Ahilan Sivaganesan, Akshitkumar Mistry et al. Traumatic atlantooccipital dislocation: comprehensive assessment of mortality, neurologic improvement, and patient-reported outcomes at a Level 1 trauma center over 15 years. 2015 Nov 1;15 11 2385 95.2015 Nov 1;15 11 2385 95. Open https://web.pathway.md/diseases/rectSjTld3LFDm9Mu 2/2