Congenital C1-2 Lateral Translational Dislocation: Case Illustration with Pre- and Postoperative Imaging

Abstract

Background: Congenital atlantoaxial dislocation has been commonly described in the antero-posterior or vertical plane (basilar invagination). However, dislocation in the lateral translational plane due to congenital deformity is rare. Case Report: We present a case of a young male who presented with os odontoideum with C1-2 dislocation in the lateral plane along with antero-posterior dislocation. He was operated on through a midline posterior incision, and the C1-2 facet was manipulated so as to correct the dislocation in all planes. Conclusion: With os odontoideum, the C1-2 joints can exhibit movements that are out of the ordinary, even in the lateral translational plane. It suggests that the ligaments and joint capsule may weaken with time. Careful radiological evaluation helps in diagnosing this rare condition. An understanding of 3D facetal anatomy is important to achieve complete correction.

Pediatric Spine Trauma

“…Violent trauma, hyperextension, or distraction injury can cause traumatic TAAS [ 52 , 67 , 82 ]. Nontraumatic cases can also arise from inflammation, facet tropism, spinal tumors, or congenital disorders including spinal fusion, Down syndrome and skeletal dysplasias [ 1 , 52 , 62 , 86 ]. Clinical presentation is diverse, from minor neck pain to myelopathy due to cord compression or cerebellar/occipital lobe infarction due to vertebral artery stenosis [ 8 , 32 , 89 ].…”