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Imamura H, Hamano Y, Kamijo H, Ichikawa M, Kashima Y, Oba H. Successful recovery from cardiac arrest due to atlantoaxial subluxation in Down syndrome: a case report. Spinal Cord Ser Cases 2024; 10:37. [PMID: 38796439 PMCID: PMC11127916 DOI: 10.1038/s41394-024-00649-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 05/02/2024] [Accepted: 05/09/2024] [Indexed: 05/28/2024] Open
Abstract
INTRODUCTION Down syndrome is the most common chromosomal abnormality associated with intellectual impairments. Unexpected deaths are common with this disease. There are certain difficulties in clarifying the cause of death because the manifestations may be quite diverse and involve many organ systems. Atlantoaxial subluxation is a dangerous complication of Down syndrome, as it may lead to cervical cord-medullary compression. CASE PRESENTATION Herein, we present a case of Down syndrome in a patient who completely recovered from cardiac arrest due to atlantoaxial subluxation. The neck was immobilized during post-cardiac arrest care, and the patient underwent surgery after 14 days. The patient could walk independently and was discharged 3 months later. At the last follow-up 5 years after surgery, the patient's general condition was good. DISCUSSION Physicians should be aware that atlantoaxial instability can cause cardiac arrest in patients with genetic syndromes.
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Affiliation(s)
- Hiroshi Imamura
- Department of Emergency and Critical Care Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
| | - Yujiro Hamano
- Department of Emergency and Critical Care Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hiroshi Kamijo
- Department of Emergency and Critical Care Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Michitaro Ichikawa
- Department of Emergency and Critical Care Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yuichiro Kashima
- Department of Emergency and Critical Care Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hiroki Oba
- Department of Orthopedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan
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Wu A, Jin H, Dou H, Pan X, Sheng S, Huang C, Wang X. Anterior decompression through transoral axis slide and rotation osteotomy for salvage of failed posterior occipitocervical fusion: a novel technique note. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:129. [PMID: 32175422 DOI: 10.21037/atm.2020.02.39] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Atlantoaxial dislocation could be caused by odontoid fractures or Os odontoideum. The previous surgical techniques in treatment of atlantoaxial dislocation were based on arch remove decompression or anterior atlantoaxial release and atlantoaxial (occipital-cervical) screw fixation-based reduction and fusion. However, for some clinical situations, all of above techniques cannot be applied. In this study, a patient with atlantoaxial dislocation caused by Os odontoideum treated by posterior occipitocervical fusion 20 years ago and failed. We design a novel anterior decompression through transoral axis slide and rotation osteotomy for salvage of this failed posterior occipitocervical fusion case. The C2 body and odontoid process was ventrally slide and rotation at good position after operation as well as the position of plate and screws, the spinal canal was increased significantly after operation too. We suggest this anterior decompression through transoral "C2 slide and rotation" technique is good choice for salvage of failed posterior occipitocervical fusion and some irreducible atlantoaxial dislocation because of the anterior bony fusion, it could direct decompress the spinal cord anteriorly, avoid the odontoid resection, and is feasible and safe technique.
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Affiliation(s)
- Aimin Wu
- Division of Spine Surgery, Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Spine Surgery Center, Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou 325027, China
| | - Haiming Jin
- Division of Spine Surgery, Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Spine Surgery Center, Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou 325027, China
| | - Haicheng Dou
- Division of Spine Surgery, Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Spine Surgery Center, Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou 325027, China
| | - Xiangxiang Pan
- Division of Spine Surgery, Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Spine Surgery Center, Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou 325027, China
| | - Sunren Sheng
- Division of Spine Surgery, Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Spine Surgery Center, Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou 325027, China
| | - Chongan Huang
- Division of Spine Surgery, Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Spine Surgery Center, Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou 325027, China
| | - Xiangyang Wang
- Division of Spine Surgery, Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang Spine Surgery Center, Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou 325027, China
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