A case of stress fracture of the atlas is reportrd. The patient was a 78-year-old woman, who had been suffering motion pain of the neck with a click sound. This pain had occurred when lifting her head on bed. She had no history of high-energy trauma. X-ray and CT scan showed fractures of both the anterior and posterior arches of the atlas without spinal canal stenosis, and MRI revealed no tumor-like lesions. As an operative treatment, atlanto-axial posterior fixation, (Brooks Method) was performed, which relieved her symptoms. For several years she had been walking bending forward, which compelled her to fully extend her neck in daily life. We assume that this posture imposed recurrent stress on the upper cervical spine, inducing the fracture of the atlas.
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