Traumatic posterior atlantoaxial dislocation (PAAD) without odontoid fracture is exceptionally rare. We report the first documented case entirely asymptomatic at presentation. A 78-year-old woman, evaluated after a motor vehicle collision, presented with no neck pain, neurological deficits, or loss of consciousness. Computed tomography scan revealed PAAD without odontoid fracture. Closed reduction was successfully performed, followed by posterior C1–C2 fixation with the Goel technique, extended to C3 due to C2–C3 instability. Postoperative imaging confirmed complete reduction, and the patient remained neurologically intact at 6-month follow-up. This case highlights the potential for silent presentation and the need for individualized management.
Andreella et al. (Thu,) studied this question.