Reduction of atlanto-occipital dislocation after cervical collar removal

Abstract

A 39-year-old male pedestrian-hit-by-car was transferred to our institution with reported intracranial hemorrhage, extensive spinal epidural hematoma, and atlanto-occipital dislocation (AOD) on outside computed tomography (CT) imaging. On arrival, he was intubated with a poor neurologic exam (GCS 3T) and had a rigid cervical collar in place. Given the reported AOD, we placed the patient flat, removed the cervical collar, and supported the head in neutral alignment with sandbags. Due to a technical issue uploading his prior imaging to our system, the patient underwent repeat CTs at our center. Subsequently, after the outside images were uploaded, we were able to compare his cervical spine CT images before and after removing his cervical collar. On comparison, we noted a substantial reduction in AOD after collar removal. The basion-dens interval (BDI) reduced from 13.0mm to 8.2mm (normative value

Document Type

Article

PubMed ID

37597660

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