J Korean Orthop Assoc.  2015 Oct;50(5):407-411. 10.4055/jkoa.2015.50.5.407.

Stress Fracture of the Anterior Atlas Arch Following C1 Posterior Arch Resection for Cervical Myelopathy with Retro-Odontoid Pseudotumor

• Song KJ
• Ham DH
• Ko JH
• Lee SK

• KMID: 2185104
• DOI: http://doi.org/10.4055/jkoa.2015.50.5.407

Abstract

Atlas fracture accounts for 1% to 3% of all spinal column injuries and 10% of cervical spine fractures, and is most frequently caused by motor vehicle accidents and falls. Only a few cases involving complications after surgical treatment have been reported. We present a case of anterior atlas arch stress fracture accompanied by worsening neurologic symptoms following atlas posterior arch resection for cervical myelopathy with retro-odontoid pseudotumor.

Keyword

cervical atlas; anterior arch; posterior arch; stress fracture

MeSH Terms

Cervical Atlas
Fractures, Stress*
Motor Vehicles
Neurologic Manifestations
Spinal Cord Diseases*
Spine

Figure

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  Figure 1 Lateral cervical radiographs showing severe degenerative spondylosis, kyphosis and instability at C1-C2. The atlanto-dental interval is 5 mm at flexion (A) and reduced at extension (B).

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  Figure 2 The retro-odontoid pseudotumor and intramedullary hyper-intense lesion of C1 and C2 were observed in sagittal (A) and axial (B) images on T2-weighted magnetic resonance imaging.

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  Figure 3 Computed tomography scans showing that C1 posterior arch resection was accomplished and that C1 anterior fracture occurred.

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  Figure 4 No changes of the retro-odontoid pseudotumor and increased intramedullary hyper-intense lesion of C1 and C2 were observed in sagittal (A) and axial (B) images on T2-weighted magnetic resonance imaging.

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  Figure 5 One year postoperative images (A: anteroposterior view, B: flexion view, C: extension view) showing adequate placement of the implants with good cervical alignment and successful posterior fusion compared with preoperative image (D).

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