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Midcervical Postinfectious Ligamentous Instability: A Variant of Grisel’s Syndrome

Midcervical Postinfectious Ligamentous Instability: A Variant of Grisel’s Syndrome Objective and Importance: We report our recent experience with two cases of C3–C4 ligamentous instability that developed after the onset of an upper airway infection. To our knowledge, this is the first report in the literature of a variant of Grisel’s syndrome occurring at the midcervical levels. The diagnosis and management of this entity are presented. Clinical Presentation: Two infants with respiratory distress were evaluated at the Children’s Hospital of Buffalo. During evaluation, cervical spine x-rays showed midcervical translational instability. Neither patient had a neurological deficit nor a history of trauma or bone disease. Intervention: One of the patients was immmobilized with an external orthosis. Conclusion: Each patient remained neurologically intact, and the cervical spine returned to normal alignment after several months. We discuss a possible mechanism for this unusual association and recommend external immobilization. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Pediatric Neurosurgery Karger

Midcervical Postinfectious Ligamentous Instability: A Variant of Grisel’s Syndrome

Lopes, Demetrius K.; Li, Veetai
Pediatric Neurosurgery , Volume 29 (3): 5 – Sep 1, 1998
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References (21)

Publisher
Karger
Copyright
© 1998 S. Karger AG, Basel
ISSN
1016-2291
eISSN
1423-0305
DOI
10.1159/000028707
Publisher site
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Abstract

Objective and Importance: We report our recent experience with two cases of C3–C4 ligamentous instability that developed after the onset of an upper airway infection. To our knowledge, this is the first report in the literature of a variant of Grisel’s syndrome occurring at the midcervical levels. The diagnosis and management of this entity are presented. Clinical Presentation: Two infants with respiratory distress were evaluated at the Children’s Hospital of Buffalo. During evaluation, cervical spine x-rays showed midcervical translational instability. Neither patient had a neurological deficit nor a history of trauma or bone disease. Intervention: One of the patients was immmobilized with an external orthosis. Conclusion: Each patient remained neurologically intact, and the cervical spine returned to normal alignment after several months. We discuss a possible mechanism for this unusual association and recommend external immobilization.

Journal

Pediatric Neurosurgery – Karger

Published: Sep 1, 1998

Keywords: Grisel’s syndrome variant; Midcervical spine anterolisthesis; Infection, upper airway

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