A Cervical Myelopathy Caused by Invaginated Anomaly of Laminae of the Axis in Spina Bifida Occulta With Hypoplasia of the Atlas

Jiang, Yuquan; Xi, Yanhai; Ye, Xiaojian; Xu, Guohua; He, Hailong; Zhu, Yun-Rong

doi:10.1097/brs.0b013e3181cb467c

Cited by 15 publications

(21 citation statements)

References 16 publications

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“…Jiang et al [6] presented a 16-year-old boy who had atlas hypoplasia and axis laminae invagination. Passias et al [7] described the coexistence of axis invagination and ossification of the posterior longitudinal ligament in a 49-year-old male patient.…”

Section: Discussionmentioning

confidence: 99%

Cervical Myelopathy Caused by Invaginated Laminae of the Axis into the Spinal Canal in a Pediatric Patient

et al. 2018

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Cervical myelopathy caused by invaginated laminae of the axis is an extremely rare entity. Advanced imaging techniques are useful to define this rare pathology and site of the spinal canal compression. Surgical removal of the floating laminae is commonly an adequate treatment method. Fusion procedures should be added in the presence of instability. There are few cases of invaginated anomalous laminae of the axis in the literature. In this report, to the best of our knowledge having reviewed the literature, the youngest and first female patient is presented.

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Section: Discussionmentioning

confidence: 99%

Cervical Myelopathy Caused by Invaginated Laminae of the Axis into the Spinal Canal in a Pediatric Patient

et al. 2018

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“…Five previously published reports of cervical myelopathy caused by invagination of an anomalous lamina of the axis have been identified [1][2][3][4][5] (Table 1). We classified these 6 reported cases into 2 groups according to presence or absence of spina bifida occulta of the axis.…”

Section: Discussionmentioning

confidence: 99%

“…Three patients (Cases 1, 3, and 5 in Table 1) had spina bifida occulta, and the other 3 (Cases 2, 4, and 6 [the patient reported here]) did not. [1][2][3][4][5] Embryologically, at the 10th week of gestation, 4 posterior vertebral arch chondrification centers unite to form 2 ossification centers on both sides of the vertebra. Each of the 2 ossification centers forms a pedicle, a lateral mass, and half of the lamina (Fig.…”

Section: Discussionmentioning

confidence: 99%

“…1,4 Of the 6 reported patients, 5 remained asymptomatic until the 4th, 5th, or 6th decade of their life. [1][2][3][4][5] Sakai et al explained that this late onset might be the result of developmental adaptation of the spinal cord. 5 Asakawa et al considered that the late-onset myelopathy might be the result of complications arising during the aging process, which caused progressive narrowing of the cervical spinal canal and spinal cord compression in a congenitally small spinal canal.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5] We describe an extremely rare case of cervical myelopathy caused by invagination of the bilaterally separated lamina of the axis and present a review of the literature. …”

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Cervical myelopathy caused by invagination of anomalous lamina of the axis

Sakaura¹,

Yasui²,

Miwa³

et al. 2013

SPI

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A lthough anomalies of the upper cervical spine are not uncommon and have multiple variations, 7 only 5 cases of cervical myelopathy caused by invagination of an anomalous lamina of the axis have been reported. [1][2][3][4][5] We describe an extremely rare case of cervical myelopathy caused by invagination of the bilaterally separated lamina of the axis and present a review of the literature. Case ReportThe patient was informed that the authors would describe his case for publication and he provided consent. History.A previously healthy 68-year-old man reported bilateral hand numbness that began 1 year before admission to Kansai Rosai Hospital in Amagasaki, Japan. During the year before admission, he had also experienced a slowly progressive gait disturbance, clumsiness of his right hand, and right dominant sensory disturbance in all 4 extremities and the trunk. He had no history of neck or head injury.Examination. Physical examination at admission revealed right dominant hypesthesia of all 4 extremities and the trunk, motor weakness of the right hand, and diffuse hyperreflexia in all extremities.A lateral radiograph of the cervical spine showed a bony abnormality in the spinal canal at the C-2 level (Fig. 1). No instability was evident on lateral flexion/extension radiographs. Magnetic resonance images taken before surgery showed that the spinal cord was markedly comCervical myelopathy caused by invagination of anomalous lamina of the axis Department of Orthopaedic Surgery, Kansai Rosai Hospital, Amagasaki, JapanThe authors report a case of cervical myelopathy caused by invagination of the bilaterally separated lamina of the axis. They also present a literature review.The patient was a previously healthy 68-year-old man with a 1-year history of slowly progressive gait disturbance, right-hand clumsiness, and right dominant sensory disturbance in his trunk and extremities. Both MRI and CT showed that the spinal cord was markedly compressed at the C2-3 level, on the right side, by a deeply invaginated anomalous lamina of the axis. A bilaterally separated lamina was also visible. The patient underwent removal of the anomalous invaginated fragment of the separated lamina and the spinous process of the axis. One year after surgery, his myelopathic symptoms had almost completely resolved.Here, the authors present the case of a patient with an extremely rare anomaly of the lamina of the axis. The underlying pathogenesis of this anomaly could be the failure of the 2 chondrification centers on either side to fuse into a single ossification center. Surgical removal of the anomalous invaginated lamina produced a satisfactory outcome.

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Combined ossification of the posterior longitudinal ligament at C2–3 and invagination of the posterior axis resulting in Myelopathy

Passias

Wang

2013

Eur Spine J

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A Cervical Myelopathy Caused by Invaginated Anomaly of Laminae of the Axis in Spina Bifida Occulta With Hypoplasia of the Atlas

Cited by 15 publications

References 16 publications

Cervical Myelopathy Caused by Invaginated Laminae of the Axis into the Spinal Canal in a Pediatric Patient

Cervical Myelopathy Caused by Invaginated Laminae of the Axis into the Spinal Canal in a Pediatric Patient

Cervical myelopathy caused by invagination of anomalous lamina of the axis

Combined ossification of the posterior longitudinal ligament at C2–3 and invagination of the posterior axis resulting in Myelopathy

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