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SPINE IMAGE
Year : 2021  |  Volume : 8  |  Issue : 4  |  Page : 65

Nightmare of a Spine Surgeon: Atlantoaxial Fixation in a Patient with Intractable Jerky Dystonia


Department of Neurosurgery, Government Medical College, Kottayam, Kerala, India

Date of Submission29-Oct-2021
Date of Acceptance29-Oct-2021
Date of Web Publication24-Dec-2021

Correspondence Address:
Parth Prakashbhai Vala
Department of Neurosurgery, Government Medical College, Kottayam, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/joss.joss_23_21

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How to cite this article:
Vala PP. Nightmare of a Spine Surgeon: Atlantoaxial Fixation in a Patient with Intractable Jerky Dystonia. J Spinal Surg 2021;8:65

How to cite this URL:
Vala PP. Nightmare of a Spine Surgeon: Atlantoaxial Fixation in a Patient with Intractable Jerky Dystonia. J Spinal Surg [serial online] 2021 [cited 2022 Jan 21];8:65. Available from: http://www.jossworld.org/text.asp?2021/8/4/65/333619

This spine image represents an unusual complication of misplaced spacer bullet cage, in the immediate postoperative period, following the atlantoaxial fixation, in a patient with intractable jerky dystonia. In this case, right spacer was seen misplaced anteriorly following rupture of the anterior longitudinal ligament [[Figure 1]a and [Figure 1]b, linear black arrow], and the left spacer was also misplaced in the posterior intermuscular plane due to constant neck movements in the postoperative period due to jerky dystonia [[Figure 1]c, curvilinear black arrow].
Figure 1: CT cervical spine and Cervico vertebral junction - (a) saggital view ,black arrow showing anteriorly discplaced spacer on right side (b) axial view, black arrow showing anteriroly displaced spacer on right side (c) saggital view, curvilinear arrow showing posteriorly displaced left spacer in post operative phase due to constant jerky dystonia

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Anteriorly displaced spacer on the right was retrieved through posterior approach along with displaced spacer in intermuscular plane on the left side under C-arm guidance followed by C1 lateral mass and C2 pedicle screws fixation. The patient went home without neurological deficits.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.




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