Grisel syndrome in pediatric age: an Italian single center experience and review of the literature.

Grisel syndrome in pediatric age: an Italian single center experience and review of the literature.

World Neurosurg. 2019 Feb 21;:

Authors: Anania P, Pavone P, Pacetti M, Truffelli M, Pavanello M, Ravegnani M, Consales A, Cama A, Piatelli G

Abstract
BACKGROUND: Non-traumatic atlanto-axial subluxation, also known as Grisel syndrome, is a rare disease that usually affects children. The typical presentation is torticollis in patients with history of surgical operations or airway infections.
MATERIAL AND METHODS: We describe 5 cases of Grisel syndrome, referring to medical care for a torticollis, few weeks after an airway infection, with no trauma associated. Radiological confirmation of the diagnosis, with CT and MRI studies, was carried out.
RESULTS: The patients were treated with external immobilization for a period of 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.
CONCLUSION: Grisel syndrome management depends on the degree of subluxation basing on Fielding and Hawkins classification. The initial non-surgical management consists of close reduction and immobilization. Surgical fixation is indicated in case of conservative treatment failure.

PMID: 30797917 [PubMed - as supplied by publisher]

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