Clinical and Anatomical Features as well as Pathological Conditions of Surgically Treated Adult Patients with Occipitalization of the Atlas

Tatara, Yasunori; Shimizu, Takahiro; Fueki, Keisuke; Ino, Masatake; Toda, Naofumi; Tanouchi, Tetsu; Manabe, Nodoka

doi:10.14444/3005

Cited by 5 publications

(4 citation statements)

References 19 publications

(16 reference statements)

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“…These symptoms may worsen with physical activity or prolonged periods of neck flexion or extension [15]. Age appears to be a significant factor in the manifestation of symptoms associated with atlas occipitalization, with most cases being diagnosed in early adulthood [16]. Additionally, there may be a genetic predisposition to this condition, although specific genetic factors contributing to its development have yet to be fully elucidated.…”

Section: Discussionmentioning

confidence: 99%

Comprehensive Physiotherapeutic Management of Atlas Occipitalization: A Case Report

Dave,

Deshmukh,

Deshmukh

2024

Cureus

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The atlas (C1) and occipital bone at the base of the skull fuse together in atlas occipitalization, an uncommon congenital abnormality. Because it can result in cervical spine instability, nerve impingement, and related symptoms including stiffness, pain, and neurological impairments, it poses a challenging therapeutic problem. We describe the case of a female patient, 27 years old, who had gradually deteriorating neck discomfort, stiffness, and limited cervical mobility for six years prior to presentation. Her symptoms worsened over time despite conservative treatment, so more testing was necessary. Atlas occipitalization, congenital fusion at the C7 and D1 vertebrae, and other related cervical spine pathologies were identified by imaging examinations. The intricacies of atlas occipitalization and related cervical spine pathologies are highlighted in this case study, along with the diagnostic difficulties and interdisciplinary therapeutic strategy needed to address them. To improve cervical range of motion (ROM), lessen discomfort, and improve functional results, the patient underwent a thorough musculoskeletal examination and was given a customized physiotherapeutic intervention.

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Section: Discussionmentioning

confidence: 99%

Comprehensive Physiotherapeutic Management of Atlas Occipitalization: A Case Report

Dave,

Deshmukh,

Deshmukh

2024

Cureus

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“…La HCO puede presentarse en pacientes con occipitalización de atlas, que corresponde a la fusión congénita del atlas con el hueso occipital (7) . Tatara et al ( 2016) analizaron las características clínicas, anatómicas y patológicas en adultos tratados quirúrgicamente con occipitalización del atlas.…”

Section: Discussionunclassified

Hipoplasia de cóndilo occipital: hallazgo en telerradiografía de perfil

et al. 2021

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Introducción: Los cóndilos occipitales y procesos articulares superiores de atlas conforman la articulación atlanto-occipital, la que contribuye en la flexión y extensión de cabeza y cuello. La hipoplasia de cóndilo occipital (HCO) esuna anomalía del desarrollo poco frecuente, pudiendo presentarse aislada o como parte de un síndrome. Si bien el diagnóstico y manejo de una HCO corresponde al área médica, es posible que en ciertos casos esta anomalía pueda ser advertida por el odontólogo. Caso: Paciente sexo femenino, 23 años, asintomática, acude a realizarse una telerradiografía de perfil, previo a tratamiento de ortodoncia. En dicha radiografía se observóuna desproyecciónen sentido vertical del arco posterior de atlas. El informe radiográfico incluyó un diagnóstico presuntivo de HCO. Posteriormente se complementó con un examen de tomografía computarizada de haz cónico (TCHC), que confirmó el diagnóstico de HCO derecho. Conclusión: La HCO puede observarse en una telerradiografía de perfil, y su diagnóstico puede realizarlo un radiólogo maxilofacial. La confirmación del diagnóstico debe realizarse con imágenes de TCHC para analizar las estructuras óseas, y con resonancia magnética para analizar los tejidos blandos circundantes.

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“…Furthermore, the assimilation of the atlas has been associated with other craniovertebral anomalies such as basilar invagination, atlantoaxial subluxation, variations of the vertebral arteries' (VAs') location, and cervical vertebral fusions [11]. The presence of blocked vertebrae between the skull and the atlas may accelerate the development of atlantoaxial instability, due to compensatory motion at the atlantoaxial joint.…”

Section: Discussionmentioning

confidence: 99%

“…A detailed CT and CTA review should be performed in order to have a better understanding of the injury and the potential anatomical variations, especially to determine the course of the vertebral arteries. A very careful and meticulous posterior dissection should be performed in all the cases with CCD but especially in those with bony assimilations and VA abnormalities, in order to decrease the risk of VA injury during the surgical approach [11]. When the VA courses above the posterior C1 arch, the placement of lateral mass screws at C1 is relatively safe.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Craniocervical Dissociation in Patients with Congenital Assimilation of the Atlas to the Occiput

Tavolaro

Pulido

Bransford

et al. 2019

Case Reports in Orthopedics

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Traumatic atlantooccipital dissociation (AOD) is a severe and usually fatal injury. Patients with assimilation of the atlas to the skull are exposed to a higher risk of injury and delay diagnosis due to the abnormal anatomy. We report two cases of acute traumatic craniocervical dislocation in patients with baseline congenital assimilation of the atlas to the skull. Computer tomography (CT) was used to identify the injury. Computer tomography angiography (CTA) showed variations of the vertebral arteries’ location on both patients. Assimilation of the atlas was complete in patient one and partial in patient two. Emergent surgical instrumentation and fusion were performed with a very careful and meticulous posterior dissection. As general rule, most of the patients with CCD will undergo occiput to C2 posterior segmental instrumentation and fusion. In the presented cases, a more extensive fusion was necessary based on the type and severity of the CCJ injury and the anatomical anomalies associated. Postoperatively, patient one remained neurologically intact and patient two died. Alternative fixation techniques should be used to minimize risk of VA injury during the surgical procedures.

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Clinical and Anatomical Features as well as Pathological Conditions of Surgically Treated Adult Patients with Occipitalization of the Atlas

Abstract: Background This paper intends to clarify clinical and anatomical features as well as pathological conditions of surgically treated adult patients with occipitalization of the atlas.

Cited by 5 publications

References 19 publications

Comprehensive Physiotherapeutic Management of Atlas Occipitalization: A Case Report

Comprehensive Physiotherapeutic Management of Atlas Occipitalization: A Case Report

Hipoplasia de cóndilo occipital: hallazgo en telerradiografía de perfil

Traumatic Craniocervical Dissociation in Patients with Congenital Assimilation of the Atlas to the Occiput

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