Occipital condyle fracture in a patient with occipitalisation of the atlas

Abstract

Occipital condyle fractures and occipitalisation of the atlas are rare entities of the craniocervical junction. To the best of our knowledge, a patient presenting with a traumatic occipital condyle fracture and pre-existing occipitalisation of the atlas has not been previously reported. We report the case of a 79-year-old man presenting with an Anderson and Montesano type III fracture through a fused occipital condyle and lateral mass. This fracture was noted to extend into the transverse foramen and the C1–C2 joint space. The transverse ligament and ligamentum flavum were calcified but not disrupted and the atlantodental interval was within normal limits. The neurological examination was unremarkable with the exception of neck pain. The patient was treated conservatively and placed in a rigid cervical collar for 10 weeks with serial CT studies to monitor healing of the fracture. At 4 months of follow-up, the patient was pain free with nearly complete resolution of his occipital condyle fracture.

Delayed Presentation of Atlanto-Occipital Dislocation with Fracture of Adjoining Bone with Diagnostic Challenge: Report of Two Cases

“…There is only one report of condylar fracture with occipitalized C1 in a 79-year-old patient with neck pain only, whereas our patient with occiptialized C1 (patient 1) had significant neurologic symptoms. 7 One report from India reveals 1% incidence of these fractures as opposed to higher incidences in the literature. 8 This may be due to limited centers and personnel capable of diagnosing these lesions and economic backgrounds of the patients who are affected due to poor access and healthcare infrastructure in low-income countries like India.…”

“…Atlanto-occipital dislocation with fracture (AODF) of adjoining bone is rare, and surgery of this location is challenging due to its complex and occasionally variable anatomy due to various malformations. [1][2][3][4][5][6][7][8][9] There are possibilities of array of traumatic dislocations of atlanto-occipital joint (AOJ) leading to deviation of location and course of the vertebral arteries. Delay in diagnosis is common, which makes the treatment more challenging because of malunions, remodeling of the dislocated or fractured segments, and change in the course of vertebral arteries.…”

Resolution of retro-odontoid cyst in a patient with atlanto-occipital assimilation after occipitocervical fixation

“…[ 8 , 9 ] It is the most common anomaly of the craniocervical junction (0.8–3.6%) and occurs more commonly in males/females (5 : 1). [ 1 , 3 , 10 ] The four patterns of occipitalization follow (e.g., Zones 1, 2, and 3; the 4 th is a combination of those zones) [ Table 1 ]. [ 2 ] Zone 2, as in our patient, involved fusion of the lateral processes (fused lateral masses).…”

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

“…Congenital assimilation of the atlas is caused by failure of segmentation between the last occipital and first cervical sclerotome during the early fetal development [5,6]. It is described in the literature as the most common anomaly of the craniocervical junction with an incidence of 0.75%-3% and a male to female ratio of 5 : 1 [7][8][9]. Complete and partial assimilation have been described.…”