caa a22 4500 445833610 CHVBK 20180317145323.0 cr unu---uuuuu 170323e20110701xx s 000 0 eng 10.1007/s00586-010-1651-z doi (NATIONALLICENCE)springer-10.1007/s00586-010-1651-z Atlanto-axial subluxation after pyogenic spondylitis of the atlanto-occipital joint [Elektronische Daten] [Kazuhiko Tsunoda, Haku Iizuka, Yasunori Sorimachi, Tsuyoshi Ara, Masahiro Nishinome, Yasuhiko Takechi, Kenji Takagishi] This report presents a case of atlanto-axial subluxation after treatment of pyogenic spondylitis of the atlanto-occipital joint. A 60-year-old male had 1-month history of neck pain with fever. Magnetic resonance imaging showed inflammation around the odontoid process. Intravenous antibiotic therapy was administrated immediately. After 6weeks, CRP had returned almost to normal. After 4months, laboratory data was still normal, but the patient experienced increasing neck pain. Lateral cervical radiography in the neutral position showed instability between C1 and C2. Computed tomography showed a bony union of the atlanto-occipital joint and severe destruction of the atlanto-axial joint on the left side. Transarticular screw fixation for the atlanto-axial joint was performed. A lateral cervical radiograph in the neutral position after surgery showed a solid bony union. Neck pain improved following surgery. We speculate that spondylitis of the atlanto-occipital joint induced a loosening of the transverse ligament and articulation of the atlanto-axial joint. A bony fusion of the atlanto-occipital joint after antibiotic treatment resolved the pyogenic inflammation concentrated stress to the damaged atlanto-axial joint, resulting in further damage. The atlanto-axial instability was finally managed by the insertion of a transarticular screw. Springer-Verlag, 2010 Atlanto-axial subluxation nationallicence Atlanto-occipital joint nationallicence Pyogenic spondylitis nationallicence Tsunoda Kazuhiko Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, 371-8511, Maebashi, Gunma, Japan aut Iizuka Haku Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, 371-8511, Maebashi, Gunma, Japan aut Sorimachi Yasunori Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, 371-8511, Maebashi, Gunma, Japan aut Ara Tsuyoshi Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, 371-8511, Maebashi, Gunma, Japan aut Nishinome Masahiro Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, 371-8511, Maebashi, Gunma, Japan aut Takechi Yasuhiko Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, 371-8511, Maebashi, Gunma, Japan aut Takagishi Kenji Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, 371-8511, Maebashi, Gunma, Japan aut European Spine Journal Springer-Verlag 20(2011-07-01), 253-257 0940-6719 20<253 2011 20 586 https://doi.org/10.1007/s00586-010-1651-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00586-010-1651-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Tsunoda Kazuhiko Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, 371-8511, Maebashi, Gunma, Japan aut NATIONALLICENCE 700 1- Iizuka Haku Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, 371-8511, Maebashi, Gunma, Japan aut NATIONALLICENCE 700 1- Sorimachi Yasunori Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, 371-8511, Maebashi, Gunma, Japan aut NATIONALLICENCE 700 1- Ara Tsuyoshi Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, 371-8511, Maebashi, Gunma, Japan aut NATIONALLICENCE 700 1- Nishinome Masahiro Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, 371-8511, Maebashi, Gunma, Japan aut NATIONALLICENCE 700 1- Takechi Yasuhiko Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, 371-8511, Maebashi, Gunma, Japan aut NATIONALLICENCE 700 1- Takagishi Kenji Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, 371-8511, Maebashi, Gunma, Japan aut NATIONALLICENCE 773 0- European Spine Journal Springer-Verlag 20(2011-07-01), 253-257 0940-6719 20<253 2011 20 586 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer