Interventional magnetic resonance imaging as a diagnostic and therapeutic method in treating acute pediatric atlantoaxial rotatory subluxation

  • Authors:
    • Juuli Hannonen
    • Marja Perhomaa
    • Niina Salokorpi
    • Willy Serlo
    • Roberto Blanco Sequeiros
    • Jaakko Sinikumpu
  • View Affiliations

  • Published online on: May 9, 2019     https://doi.org/10.3892/etm.2019.7565
  • Pages: 18-24
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )


Abstract

Atlantoaxial rotatory subluxation or fixation (AARF) is a rare condition, usually occurring in pediatric patients. It mimics benign torticollis but may result in permanent disability or death. The condition requires prompt diagnosis by thorough examination to avoid any treatment delays. Spiral computed tomography (CT) with three‑dimensional reconstruction CT is recommended for identifying incongruence between C1 and C2 vertebrae, and magnetic resonance imaging (MRI) may be performed to exclude ligamentous injuries. In addition to static imaging, dynamic CT involves the reduction between C1 and C2 being confirmed using CT with the head turned maximally to the left and right. The present report (level of evidence, III) provides a method for treating AARF that has similar advantages as dynamic CT but avoids ionizing radiation by replacing CT with interventional MRI. The new method comprised simultaneous axial traction and manual closed reduction, performed under general anesthesia, and the use of interventional MRI to ensure that reduction was achieved and held. The head is turned maximally to the right and left during the manual reduction. A rigid cervical collar was used following reduction. Dynamic CT was not required but prior diagnostic static CT was performed in preparation. No further CT was required. There appears to be no previous studies on interventional MRI in AARF care. Being superior in its diagnostic soft‑tissue visualization performance and lacking ionizing radiation, interventional MRI is a potential option for investigating and treating acute AARF in non‑syndromic patients with no trauma history.
View Figures
View References

Related Articles

Journal Cover

July-2019
Volume 18 Issue 1

Print ISSN: 1792-0981
Online ISSN:1792-1015

Sign up for eToc alerts

Recommend to Library

Copy and paste a formatted citation
x
Spandidos Publications style
Hannonen J, Perhomaa M, Salokorpi N, Serlo W, Sequeiros RB and Sinikumpu J: Interventional magnetic resonance imaging as a diagnostic and therapeutic method in treating acute pediatric atlantoaxial rotatory subluxation. Exp Ther Med 18: 18-24, 2019
APA
Hannonen, J., Perhomaa, M., Salokorpi, N., Serlo, W., Sequeiros, R.B., & Sinikumpu, J. (2019). Interventional magnetic resonance imaging as a diagnostic and therapeutic method in treating acute pediatric atlantoaxial rotatory subluxation. Experimental and Therapeutic Medicine, 18, 18-24. https://doi.org/10.3892/etm.2019.7565
MLA
Hannonen, J., Perhomaa, M., Salokorpi, N., Serlo, W., Sequeiros, R. B., Sinikumpu, J."Interventional magnetic resonance imaging as a diagnostic and therapeutic method in treating acute pediatric atlantoaxial rotatory subluxation". Experimental and Therapeutic Medicine 18.1 (2019): 18-24.
Chicago
Hannonen, J., Perhomaa, M., Salokorpi, N., Serlo, W., Sequeiros, R. B., Sinikumpu, J."Interventional magnetic resonance imaging as a diagnostic and therapeutic method in treating acute pediatric atlantoaxial rotatory subluxation". Experimental and Therapeutic Medicine 18, no. 1 (2019): 18-24. https://doi.org/10.3892/etm.2019.7565