Atlantoaxial Subluxation in Auto Accidents

There is always a chance that someone could suffer a serious injury if they are involved in an auto accident. One of the most serious injuries that someone might sustain is called an atlantoaxial subluxation, an injury that could possibly result in death. A recent series of case reports were published in literature describing how people can sustain this injury if they are involved in an auto accident.

Atlanto-axial subluxation is the term given to the misalignment of the first and second cervical vertebrae of the spine. The first vertebra is called the atlas, and the second vertebra is called the axis. The second vertebra is connected to the first vertebrae like a nail in a piece of plywood. These are the first two vertebrae in the entire spinal cord, resting directly beneath the brainstem. Some people are at greater risk of suffering this subluxation if they have congenital atlantoaxial instability, a common disorder seen in individuals with Down Syndrome.

When someone develops this subluxation, they could notice a wide variety of symptoms depending on the severity of the injury. Some people could have a vague headache, neck, or back pain. If this traumatic injury is not corrected, it could lead to chronic pain. If the misalignment between the two vertebrae is particularly severe, this injury could lead to spinal cord compression at the cervical level. People could notice changes in the heart rate, breathing rate, or blood pressure, possibly resulting in death.

Fortunately, traumatic injuries to the atlas and axis aren’t common; however, there are a few mechanisms by which people can sustain injuries to these two important vertebrae. These include:

• Diving: One of the most common ways people sustain injuries to the atlas and axis is by diving into a too shallow pool. Most people have seen the warnings on the edges of shallow pools that say “no diving” due to the depth of the pool. If people dive into a pool that is too shallow, they could strike the bottom before they surface. In this case, people could hit their heads on the bottom of the pool. These forces can lead to a series of compression bone fractures involving the atlas and axis, leading to the two vertebrae impacting the brainstem. This can quickly result in wrongful death.
• Auto Accidents: People can also develop traumatic atlas and axis rotary injuries when they are involved in an auto accident. When people drive and collide with a car or object in front of them, they feel the sudden change in momentum. Fortunately, if they are wearing their seatbelt, their body is restrained from striking the steering wheel and dashboard in front of them; however, there is no such belt for the head. Because of this, people can strike the steering wheel or dashboard with their head at extreme forces, potentially leading to atlantoaxial subluxation.

A team of medical professionals published two different case reports where individuals sustained these serious injuries in auto accidents. The first individual was a female driver in her mid-30s. She entered a construction zone while driving at high speeds and collided with a concrete barrier. Her car rotated multiple times, and her head struck the window of the vehicle. The second individual was a teenage male who lost control of his vehicle in the middle of the night. His vehicle struck a tree head-on.

In both cases, the individuals were managed with a cervical collar at the scene, which was used to immobilize the spine and prevent further damage. The patients were transported to the local hospital, where pain medication was given, and imaging procedures were performed. In both cases, imaging revealed damage to the atlas and axis. The two vertebrae were rotated completely out of alignment with each other, along with damage to the associated ligaments and facet joints.

Fortunately, the degree of misalignment was not severe. The patients were immobilized in a collar for six weeks to allow the injuries to heal. Both individuals made a full recovery and were able to return to their normal activity. Other people may not fair as well.

In some cases, auto accidents can result due to the negligence of someone else. They include:

• Individuals who are guilty of drunk driving
• Driving while talking on the phone or texting
• Operating a motor vehicle while under the influence of narcotic medications

When people decide to drive while seriously impaired, they are placing not only themselves but also other people at risk. This can lead to serious injuries that could have otherwise been avoided. Therefore, it is important to speak with an experienced Sacramento personal injury lawyer to learn more. Medical bills can be expensive, and it is important to learn about all of the options available for covering these costs before making any decisions.

I’m Ed Smith, a Sacramento Personal Injury Lawyer. If you have developed spinal trauma in a traumatic accident, please call us for free, friendly advice. We can be reached at 916.921.6400 or 800.404.5400.

We are members of the National Association of Distinguished Counsel and the Million Dollar Advocates Forum.

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Editor’s Note: This page has been updated for accuracy and relevancy [cha 3.24.21]

Photo by Karolina Grabowska from Pexels

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