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首页> 外文期刊>Spine >Atlantoaxial rotatory fixation-subluxation revisited: a computed tomographic analysis of acute torticollis in pediatric patients.
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Atlantoaxial rotatory fixation-subluxation revisited: a computed tomographic analysis of acute torticollis in pediatric patients.

机译：寰枢椎旋转固定半脱位复查：儿科患者急性斜颈的计算机断层扫描分析。

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STUDY DESIGN: Cross-sectional clinical and radiologic study with a normal control group. OBJECTIVES: To compare the range of motion of the atlantoaxial joint in patients with acute torticollis with those of normals as measured from computed tomography scans, to look for the existence of atlantoaxial rotatory fixation in any position (subluxation or normal range of motion) in this group of patients, and to clarify the definition of atlantoaxial rotatory subluxation by measuring the atlantodental interval and analyzing the location of the center of rotation in patients as well as normal controls. SUMMARY OF BACKGROUND DATA: Although acute acquired torticollis is usually termed atlantoaxial rotatory subluxation or atlantoaxial rotatory fixation, the radiologic definition of these conditions is not clear. PATIENTS AND METHODS: Thirty-three consecutive pediatric patients (average age 8.5 years, range 2-18 years) with acute acquired torticollis were analyzed. All were neurologically intact. Anteroposterior and lateral radiographs were obtained in all atlantoaxial computed tomography scans in 31 patients (dynamic in 23 and static in 8). Twelve age-matched patients with normal cervical spines were also analyzed with dynamic computed tomography as normal controls. Atlantoaxial rotatory subluxation, atlantoaxial angle, center of rotation, and presence of atlantoaxial rotatory fixation were analyzed in each computed tomography. All patients were treated conservatively. Eight had control dynamic computed tomography scans at the end of the treatment. RESULTS: All patients had atlantoaxial rotatory subluxation
机译：研究设计：正常对照组的横断面临床和放射学研究。目的：比较计算机断层扫描所测得的急性斜颈患者的寰枢关节运动范围与正常人的寰枢关节运动范围，以寻找在此任何位置（半脱位或正常运动范围）存在寰枢椎旋转固定的情况。并通过测量患者的牙齿间隔和分析患者以及正常对照者的旋转中心位置来阐明寰枢椎旋转半脱位的定义。背景资料概述：尽管急性获得性斜颈通常被称为寰枢椎旋转半脱位或寰枢椎旋转固定，但这些情况的放射学定义尚不清楚。患者与方法：分析了33例连续性急性获得性斜颈的儿科患者（平均年龄8.5岁，范围2-18岁）。所有的神经系统均完好无损。在31例患者的所有寰枢计算机X线断层扫描中获得前后位和侧位X线照片（动态23例，静态8例）。还对十二名年龄相匹配的颈椎正常的患者进行了动态计算机断层扫描作为正常对照。在每个计算机断层扫描中分析了寰枢椎旋转半脱位，寰枢椎角度，旋转中心和寰枢椎旋转固定。所有患者均接受保守治疗。在治疗结束时，有八名进行了动态控制计算机断层扫描。结果：所有患者的寰枢椎旋转半脱位<或= 3 mm。在动态计算机断层扫描上，寰枢椎旋转范围是朝向畸形的30.4度（11-54度）和远离畸变的28.3度（18-54度）（P = 0.333）。在所有患者中均未发现寰枢椎旋转固定。正常对照组的相同测量值是28度（5-41度）（P = 0.770）。在8例重复控制的X线断层摄影术中，寰枢椎旋转半脱位在治疗前26度和治疗后29度（右P = 0.691，左​​P = 0.199）。旋转中心在19个病人中的15个位于窝内，在19个病人中的2个位于窝外，而在19个病人中的2个中未检测到。在11中的1中，所有患者在保守治疗结束后均无症状。结论：我们不能证明33例连续小儿急性斜颈患者的寰枢椎旋转半脱位或寰枢椎旋转固定。我们的发现表明，这些现象的存在值得怀疑，尽管与急性后天性斜颈无关。急性获得性斜颈不​​一定是寰枢关节病理状况的征兆。最后，在就诊时这组患者可能不需要进行计算机断层扫描（静态或动态）。

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