Grisel Syndrome in Pediatric Age: A Single-Center Italian Experience and Review of the Literature.
Atlanto-Axial Joint
/ injuries
Child
Female
Humans
Immobilization
/ instrumentation
Joint Dislocations
/ surgery
Male
Mycoplasma Infections
/ complications
Mycoplasma pneumoniae
Orthopedic Fixation Devices
Quality of Life
Respiratory Tract Infections
/ complications
Streptococcal Infections
/ complications
Streptococcus pyogenes
Syndrome
Torticollis
/ etiology
Treatment Outcome
Atlantoaxial subluxation
Grisel
Torticollis
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
05 2019
05 2019
Historique:
received:
14
11
2018
revised:
05
02
2019
accepted:
06
02
2019
pubmed:
25
2
2019
medline:
19
11
2019
entrez:
25
2
2019
Statut:
ppublish
Résumé
Nontraumatic atlantoaxial subluxation, also known as Grisel syndrome, is a rare disease that usually affects children. The typical presentation is torticollis in patients with a history of surgical operations or airway infections. We describe 5 patients with Grisel syndrome, referring to medical care for a torticollis, a few weeks after an airway infection, with no trauma associated. Radiologic confirmation of the diagnosis, with computed tomography and magnetic resonance imaging studies, was carried out. The patients were treated with external immobilization for 3 months, followed by surgical fixation in the case of recurrence after collar removal or inveterate subluxation. We performed a review of the literature to define the best management of this disease. Management of Grisel syndrome depends on the degree of subluxation basing on the Fielding and Hawkins classification. The initial nonsurgical management consists of close reduction and immobilization. Surgical fixation is indicated in cases of conservative treatment failure.
Sections du résumé
BACKGROUND
Nontraumatic atlantoaxial subluxation, also known as Grisel syndrome, is a rare disease that usually affects children. The typical presentation is torticollis in patients with a history of surgical operations or airway infections.
METHODS
We describe 5 patients with Grisel syndrome, referring to medical care for a torticollis, a few weeks after an airway infection, with no trauma associated. Radiologic confirmation of the diagnosis, with computed tomography and magnetic resonance imaging studies, was carried out.
RESULTS
The patients were treated with external immobilization for 3 months, followed by surgical fixation in the case of recurrence after collar removal or inveterate subluxation. We performed a review of the literature to define the best management of this disease.
CONCLUSIONS
Management of Grisel syndrome depends on the degree of subluxation basing on the Fielding and Hawkins classification. The initial nonsurgical management consists of close reduction and immobilization. Surgical fixation is indicated in cases of conservative treatment failure.
Identifiants
pubmed: 30797917
pii: S1878-8750(19)30446-2
doi: 10.1016/j.wneu.2019.02.035
pii:
doi:
Types de publication
Case Reports
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
374-382Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.