<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1870-7203</journal-id>
<journal-title><![CDATA[Acta médica Grupo Ángeles]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. Grupo Ángeles]]></abbrev-journal-title>
<issn>1870-7203</issn>
<publisher>
<publisher-name><![CDATA[Grupo Ángeles, Servicios de Salud]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1870-72032016000400235</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Inestabilidad atlantoaxoidea]]></article-title>
<article-title xml:lang="en"><![CDATA[Atlantoaxial instability: report of a case]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Alcocer Maldonado]]></surname>
<given-names><![CDATA[José Luis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Domínguez Gasca]]></surname>
<given-names><![CDATA[Luis Gerardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mora Constantino]]></surname>
<given-names><![CDATA[Jorge]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Domínguez Carrillo]]></surname>
<given-names><![CDATA[Luis Gerardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital General de León Servicio de Neurocirugía ]]></institution>
<addr-line><![CDATA[León Guanajuato]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital General de León  ]]></institution>
<addr-line><![CDATA[León Guanajuato]]></addr-line>
<country>México</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Ángeles León Servicio de Imagenología ]]></institution>
<addr-line><![CDATA[León Guanajuato]]></addr-line>
<country>México</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Universidad de Guanajuato Facultad de Medicina de León ]]></institution>
<addr-line><![CDATA[León Guanajuato]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2016</year>
</pub-date>
<volume>14</volume>
<numero>4</numero>
<fpage>235</fpage>
<lpage>239</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S1870-72032016000400235&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S1870-72032016000400235&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S1870-72032016000400235&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Antecedentes:  La inestabilidad atlantoaxial, conocida también como subluxación atlantoaxial, sólo es identificada radiológicamente, por movilidad o laxitud incrementada entre el cuerpo del atlas y el proceso odontoideo. Cuando una persona tiene inestabilidad atlantoaxial, la incompetencia del ligamento transverso o el daño del proceso odontoideo permiten su traslación posterior y, potencialmente, dañar a la médula espinal; por ello, todo individuo con inestabilidad confirmada tiene restricción de participar en deportes de contacto y aquellos que requieren flexión o extensión cervical significante.  Caso clínico:  Paciente femenina de nueve años, practicante de gimnasia durante los últimos cuatro años a nivel competitivo. Inició su padecimiento al caer con hiperflexión del cuello de una cama elástica de entrenamiento; fue manejada inicialmente con diagnóstico de esguince cervical grado I; se efectuaron radiografías dinámicas de la columna cervical y resonancia magnética, que mostraron datos de subluxación atlantoaxoidea e inflamación en el espacio atlantoodontoideo, la cual requirió de cirugía tras un tratamiento conservador fallido.  Conclusiones:  El tratamiento quirúrgico en los casos con inestabilidad atlantoaxoidea asintomática está sujeto a controversia; la fusión en individuos asintomáticos está indicada para reducir el riesgo de lesión medular.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Background:  Atlantoaxial instability, also known as atlantoaxial subluxation, is only identified by radiographic studies with laxity increased between the anterior arch of the atlas and the odontoid process. When a patient has atlantoaxial instability, the incompetence of the transverse ligament or damage to the odontoid process allows a subsequent translation, with potential damage to the spinal cord; therefore, all patients with confirmed instability are restricted from participating in contact sports and sports that require bending or significant cervical flexo-extension.  Case report:  Nine-year-old female patient; she had practiced gymnastics for the past four years at a competitive level. She began her condition with a neck hyperflexion when falling down from trampoline training; she was managed in the emergency room with a diagnosis of cervical sprain grade I; dynamic radiographic studies and MRI were performed, which showed atlantoaxial subluxation and evidence of inflammation in the atlanto-odontoid space. She required surgery after a failed conservative treatment.  Conclusions:  Surgical treatment in patients with asymptomatic atlantoaxial subluxation is subject to controversy; arthrodesis is indicated in asymptomatic individuals to reduce the risk of spinal cord injury.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Subluxación atlantoaxial]]></kwd>
<kwd lng="es"><![CDATA[inestabilidad atlantoaxial]]></kwd>
<kwd lng="en"><![CDATA[Atlantoaxial subluxation]]></kwd>
<kwd lng="en"><![CDATA[atlantoaxial instability]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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