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題名 | Treatment of Atlantoaxial Rotatory Fixation With Botulinum Toxin Muscle Block and Manipulation=旋轉性寰樞椎關節固定之肉毒桿菌肌肉阻斷治療及徒手治療 |
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作者 | 林家弘; 陳春榮; 陳全木; 廖素蘭; 阮淑玲; 蔡森蔚; | 書刊名 | Journal of the Chinese Medical Association |
卷期 | 73:4 2010.04[民99.04] |
頁次 | 頁222-224+CA39 |
關鍵詞 | 寰樞椎關節旋轉性固定; 肉毒桿菌; 徒手治療; Atlantoaxial rotatory fixation; Botulinum toxin; Manipulation; |
語文 | 英文(English) |
英文摘要 | Slippage after reduction of atlantoaxial rotatory fixation (AARF) is usually treated with repeated cervical traction and brace immobilization. To date, no data have been published on the management of muscle spasm during treatment. Here, we describe the case of a 7-year-old girl with AARF for 1 month who visited our hospital for treatment. During physical examination, spasm of the sternocleidomastoid muscle was noted. The patient was treated with manipulative reduction, and slippage after reduction was managed with botulinum spasticity block of the sternocleidomastoid and splenius capitis muscles, and repeated manipulation. Cervical orthosis immobilization with a rehabilitation program of isometric contract– relax exercise for the neck was conducted for 3 months. The subject had full recovery from AARF at 1-year follow-up. This report demonstrates that, in selected cases of slippage after reduction from AARF, conservative management with manipulation under anesthesia is a good method, and the muscle components may play a crucial role in AARF. |
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