Tu CQ, Chen ZD, Yao XT, Jiang YJ, Zhang BF, Lin B. Posterior pedicle screw fixation combined with local steroid injections for treating axial eosinophilic granulomas and atlantoaxial dislocation: A case report. World J Clin Cases 2023; 11(20): 4944-4955 [PMID: 37583995 DOI: 10.12998/wjcc.v11.i20.4944]
Corresponding Author of This Article
Bin Lin, Doctor, Adjunct Professor, Chief Doctor, Chief Physician, Department of Orthopedic Surgery, The 909th Hospital, School of Medicine, Xiamen University, No. 269 Zhanghua Middle Road, Zhangzhou 363000, Fujian Province, China. linbin813@163.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jul 16, 2023; 11(20): 4944-4955 Published online Jul 16, 2023. doi: 10.12998/wjcc.v11.i20.4944
Posterior pedicle screw fixation combined with local steroid injections for treating axial eosinophilic granulomas and atlantoaxial dislocation: A case report
Cheng-Quan Tu, Zhi-Da Chen, Xiao-Tao Yao, Yuan-Jie Jiang, Bi-Fang Zhang, Bin Lin
Cheng-Quan Tu, Zhi-Da Chen, Xiao-Tao Yao, Yuan-Jie Jiang, Bi-Fang Zhang, Bin Lin, Department of Orthopedic Surgery, The 909th Hospital, School of Medicine, Xiamen University, Zhangzhou 363000, Fujian Province, China
Cheng-Quan Tu, Bi-Fang Zhang, School of Medicine, Xiamen University, Xiamen 361005, Fujian Province, China
Author contributions: Tu CQ and Chen ZD have contributed equally to this work and share the first authorship; Tu CQ and Chen ZD were responsible for data collation and primary manuscript generation; Lin B, Jiang YJ and Zhang BF were responsible for manuscript editing; Lin B and Yao XT were the senior authors who performed the surgery and contributed to the study design; all authors have read and approve the final manuscript.
Supported bythe Natural Science Foundation of Fujian Province, No. 2021J01546; and the Innovation and Entrepreneurship Star Fund Project of Zhangzhou, No. ZCZZ[2019]17.
Informed consent statement: Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bin Lin, Doctor, Adjunct Professor, Chief Doctor, Chief Physician, Department of Orthopedic Surgery, The 909th Hospital, School of Medicine, Xiamen University, No. 269 Zhanghua Middle Road, Zhangzhou 363000, Fujian Province, China. linbin813@163.com
Received: April 9, 2023 Peer-review started: April 9, 2023 First decision: May 8, 2023 Revised: May 23, 2023 Accepted: June 21, 2023 Article in press: June 21, 2023 Published online: July 16, 2023 Processing time: 93 Days and 21.9 Hours
Abstract
BACKGROUND
Eosinophilic granuloma (EG) is a proliferative condition that affects the cells of bone tissue. There are no specific clinical signs or imaging manifestations in the early stages of the disease, making it simple to overlook and misdiagnose. Because of the disease's rarity, there is presently no standardized treatment principle. There are few accounts of such occurrences affecting the axis among children. We discovered a case of a child whose EG resulted in atlantoaxial joint dislocation and destruction of the axial bone.
CASE SUMMARY
After having pharyngeal discomfort for more than six months without a clear explanation, a 6-year-old boy was brought to our hospital. Following a careful evaluation, the pathology indicated a strong likelihood of an axial EG. Ultimately, we decided to treat the boy with posterior pedicle screw fixation and local steroid injections.
CONCLUSION
EGs of the upper cervical spine are quite uncommon in children, and they are exceedingly easy to overlook or misdiagnose. Posterior pedicle screw fixation and local steroid injections are effective treatments for patients with axial EGs affecting the atlantoaxial junction.
Core Tip: One rare cause of neck pain is axial eosinophilic granuloma. Patients with abrupt neck discomfort should be evaluated with a radiological investigation. This study illustrates that axial eosinophilic granuloma with atlantoaxial joint dislocation can be treated with posterior pedicle screw fixation combined with local steroid injections and that histopathological biopsy is an excellent diagnostic tool for verifying the condition.
