PMC7771491_01
Preoperative CT cervical spine. Sagittal (a), coronal (b), and axial (c and d) bone window CT cervical spine images demonstrate the right atlanoaxial rotatory subluxation (arrows), where the atlas has rotated on the odontoid with no anterior displacement.
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F1
In addition, the CT showed a unilateral atlantoaxial rotatory subluxation with a locked right C1 facet and a right-sided intracanalicular bony fragment adjacent to the odontoid process [Figure 1a-d].
Preoperative axial T2W MRI image shows the rotatory subluxation (arrow).
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F2
Further, the transverse and alar ligaments remained intact (Fielding Type I AARS injury) [Figure 2].
Postoperative CT cervical spine. Sagittal (a), coronal (b), and axial (c) bone window CT cervical spine day 2 after surgery demonstrates the restoration of C1-C2 alignment.
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F3
Further, at 6 months post-surgery, she was fully neurologically intact [Figures 3 and 4].
Flexion (a) and extension (b) cervical spine X-ray at 3 months follow-up shows absence of C1-C2 instability.
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F4
Further, at 6 months post-surgery, she was fully neurologically intact [Figures 3 and 4].