軽微な外傷を契機に発症した高齢者環軸関節回旋位固定の1例

Atlantoaxial Rotatory Fixation Caused by Minor Trauma in Elderly Patiant. Case Report

　高齢者における環軸関節回旋位固定は稀であるが，今回われわれは，過去に報告のない，軽微な外傷を契機に発症した1例を経験したので報告する．症例は78歳，女性．浴室にて壁に頭部を打撲し，その後徐々に頚部痛，斜頚が進行し環軸関節回旋位固定に至った．CTにて，環椎の横靱帯付着部に剝離骨折と思われる骨片を認めた．C1後弓切除術およびC0～C3に至る頭蓋頚椎後方固定術を行い，良好な成績を得た．高齢者では，たとえ軽微な外傷であっても，斜頚が発生した場合には，環軸関節回旋位固定が発症しうることを念頭に置くべきである．

　A rare case of atlantoaxial rotatory fixation in an elderly patient, which has never been described before, is reported. A 78-year-old woman developed neck pain and torticollis after hitting her head against the bathroom wall. X-rays revealed atlantoaxial rotatory fixation, and CT demonstrated an avulsion fracture of the atlas at the insertion of the transverse ligament. A favorable outcome was obtained by C1 laminectomy and posterior occipitocervical (C0-C3) fusion. When torticollis develops after minor trauma, the possibility of atlantoaxial rotatory fixation should be considered, even in elderly patients.