A Success Story: A rare case of Fixed Atlanto Axial Dislocation

A 36 years old Man : Concerned about his condition

A 36-year-old Mr. Shah, presented to the Department of Orthopaedic Spine Surgery at Artemis Hospitals, Gurgaon, with a persistent neck pain that radiates to his left shoulder. Accompanying this discomfort were episodes of numbness and tingling in his left arm. Now the patient has started getting progressive weakness in arms and legs.  Concerned about his condition, Mr. Shah sought the expertise of the spine surgeons at Artemis.

Examination & Diagnosis

Upon a thorough examination, including MRI and a 3D reconstruction of a CT scan with angiography, the surgical team diagnosed Mr. Shah with a Fixed Atlanto Axial Dislocation (AAD).

This rare condition involves the misalignment of the first two vertebrae in the neck (the atlas and the axis). The first vertebra known as C1 or Atlas was fused to occiput (skull bone) and had dislocated in front of C2, the 2nd vertebra or Axis.

Treatment

The c2 bone had gone into the skull (condition is known as basilar invagination) and thus compressing the spinal cord leading to weakness in arms and legs. Given the severity of his condition and the potential risks associated with AAD, the surgeons advised Mr. Shah to undergo a posterior cervico-occipital fusion and fixation surgery with reduction of basilar invagination. 

In this surgery, C1C2 joint were opened up and large spacers were inserted into the joints and thus bringing the C2 bone down and out of skull leading to relief of compression over spinal cord. Important to note is that the entire surgery was done on the bones and joints, away from spinal cord and nerves, achieving indirect decompression of nerves and spinal cord via reduction of maligned joints.

During the Surgery

The surgery at Artemis Hospitals was a complex undertaking, requiring advanced technology and a high degree of surgical skill. The use of O-arm and C-arm imaging systems provided real-time guidance during the procedure, ensuring accurate placement of screws and rods.

Neuromonitoring technology was employed to monitor the patient’s neurological function throughout the surgery, minimizing the risk of complications. Additionally, the 3D CT scan technology aided in pre operative planning and intraoperative navigation.

After the Suregry

Thanks to the expertise of the spine surgeons, the advanced technology used, and Mr. Shah’s overall health, the surgery was a resounding success. Post-surgery, Mr. Shah experienced significant relief from his neck pain, numbness weakness, and tingling. He was able to resume his normal activities gradually, and his quality of life improved dramatically.

Mr. Shah’s case underscores the importance of early diagnosis and appropriate treatment for conditions like AAD. The successful outcome of his surgery at Artemis Hospitals highlights the hospital’s commitment to providing state-of-the-art care and achieving excellent patient outcomes.