Jefferson骨折を伴った環軸椎回旋位固定の1例

A case of atlanto-axial rotatory fixation associated with Jefferson's fracture

I．はじめに

　環軸椎脱臼は，ほとんどが前方脱臼であり回旋性の脱臼はまれである^2,6,8）．われわれは，環椎破裂骨折（Jef—ferson's fracture）を伴った環軸椎回旋位固定（at—lanto-axial rotatory fixation）の成人例を経験したので，診断および治療上の問題点に関して考察を加えて報告する．

The authors present a case of atlanto-axial rotatory fixation associated with Jefferson's fracture. A 52-year-old man was admitted to our hospital complaining of severe neck pain and torticollis after a traffic accident. Cervical x-ray films showed fracture of the atlas. CT scans demonstrated traumatic subarachnoid hemor-rhage and atlanto-axial rotatory fixation. The patient was managed with skull traction and reposition was achieved. Although he was maintained in a halo device for 4 months, rotary fixation recurred. He underwent posterior fusion between the atlas and axis.

We review the literature and discuss the diagnostic problems and methods of treatment for atlanto-axial rotatory fixation.