Posterior atlantoaxial subluxation due to os odontoideum combined with cervical spondylotic myelopathy : a case report

• Published in: European spine journal Vol. 17; no. Suppl 2; pp. 275 - 279
• Main Authors: Motosuneya, Takao, Hirabayashi, Shigeru, Yamada, Hironobu, Kobayashi, Yousuke, Sekiya, Shigeki, Sakai, Hiroya
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.09.2008; Springer Nature B.V
• Subjects: Aged; Atlanto-Axial Joint - diagnostic imaging; Atlanto-Axial Joint - pathology; Atlanto-Axial Joint - physiopathology; Case Report; Decompression, Surgical - instrumentation; Decompression, Surgical - methods; Female; Gait Disorders, Neurologic - diagnostic imaging; Gait Disorders, Neurologic - etiology; Gait Disorders, Neurologic - pathology; Humans; Internal Fixators; Joint Dislocations - etiology; Joint Dislocations - pathology; Joint Dislocations - surgery; Laminectomy - instrumentation; Laminectomy - methods; Medicine; Medicine & Public Health; Neurosurgery; Neurosurgical Procedures - instrumentation; Neurosurgical Procedures - methods; Odontoid Process - abnormalities; Odontoid Process - diagnostic imaging; Odontoid Process - pathology; Spinal Cord Compression - complications; Spinal Cord Compression - pathology; Spinal Cord Compression - surgery; Spinal Fusion - instrumentation; Spinal Fusion - methods; Spinal Stenosis - diagnostic imaging; Spinal Stenosis - etiology; Spinal Stenosis - pathology; Spondylosis - complications; Spondylosis - diagnostic imaging; Spondylosis - pathology; Surgical Orthopedics; Tomography, X-Ray Computed; Treatment Outcome; Cervical spondylotic myelopathy; Posterior atlantoaxial subluxation; Os odontoideum
• ISSN: 0940-6719; 1432-0932
• DOI: 10.1007/s00586-007-0565-x

In patients with os odontoideum and posterior atlantoaxial subluxation are extremely rare. No reports have described posterior atlantoaxial subluxation associated with os odontoideum combined with cervical spondylotic canal stenosis, both of which require surgical treatment. We report one case of a 75-year-old female who underwent arthrodesis between the occiput and C3 using a hook-and-rod system and also a double-door laminoplasty from levels C3 to C7. The claw mechanism was applied between the C2 lamina and the C3 inferior articular process. The posterior atlantoaxial subluxation was completely reduced by the method that the rod gradually pushed the posterior arch of C1 anteriorly during connection to the occiput. Twelve months after surgery, the patient showed improvement in preoperative clumsiness and gait disturbance, and the latest plain radiographs showed solid osseous fusion, with no loss of correction or instrumentation failure.