Radiographic and Clinical Results of C1 Laminoplasty for the Treatment of Compressive Myelopathy

Tarukado, Kiyoshi; Ikuta, Kentaro; Iida, Keiichiro; Tono, Osamu; Doi, Takehiko; Harimaya, Katsumi

doi:10.31616/asj.2019.0190

Cited by 8 publications

(3 citation statements)

References 20 publications

(37 reference statements)

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“…described how C1 laminoplasty performed for spinal cord compression at the C1/2 level resulted in favorable outcomes, and, therefore suggested this might be an effective alternative to CIL for patients without C1–C2 instability. [ 5 ] Shimizu et al . described a 14.2% (10 patients) incidence of C1 anterior atlas arch fractures in 70 patients who had undergone C1L without fusion.…”

Section: Discussionmentioning

confidence: 99%

A case of anterior arch fracture of the atlas associated with C1 laminectomy

Kawasaki

Takayama

Maki

et al. 2023

Surgical Neurology International

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Background: Spontaneous anterior arch fracture of the atlas after a C1 laminectomy (CIL) is an extremely rare complication. Case Description: A 72-year-old male presented with the sudden onset of neck pain. His prior history included; a CIL for atlantoaxial subluxation, shunt closure for a spinal dural arteriovenous fistula at C3, a cervical laminoplasty from C3 to C6 for stenosis, and a prior anterior C4/5 and C5/6 fusion 14 years ago. Once the computed tomography documented a right C1 anterior arch fracture, and occipital-cervical fusion was performed utilizing C2 laminar screws and C4 pedicle screws with halo-vest placement. Postoperatively, the neck pain resolved and he remained stable. Conclusion: Neurosurgeons should be aware of the risk of anterior arch fractures following a CIL and may alternatively consider a C1 laminoplasty in the future.

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Section: Discussionmentioning

confidence: 99%

A case of anterior arch fracture of the atlas associated with C1 laminectomy

Kawasaki

Takayama

Maki

et al. 2023

Surgical Neurology International

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“…Due to the patient's osteoporosis and anterolateral rotatory angulated type IIA dens fracture fragment, we assumed that a forceful reduction of the atlantoaxial anteroinferior subluxation with kyphosis to a neutral or lordotic state could cause a high risk of fixation failure and spinal cord injury. [ 10 – 12 ] Notably, C2 pedicle screw fixation is biomechanically stronger than C2 lamina screw fixation. [ 4 ] However, we deemed the insertion of C2 pedicle screws technically challenging because of fractures of both pars interarticularis and the type IIA dens fracture.…”

Section: Discussionmentioning

confidence: 99%

Traumatic atlantoaxial anteroinferior subluxation with dens and Hangman fractures

et al. 2021

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Rationale: Traumatic atlantoaxial anteroinferior subluxation associated with a dens fracture and a Hangman fracture is a very rare and complex injury. Therefore, appropriate surgical strategy is not established. Patient concerns: An 85-year-old female presented with posterior neck pain and atypical neck position caused after rolling down a hill. Although neurological examinations for motor, sensory, gait, and reflex tests were normal, the patient complained of an abnormal neck posture. Diagnoses: Radiological examinations revealed an atlantoaxial anteroinferior subluxation with kyphosis, a type IIA dens fracture (Anderson and D’Alonzo classification) with an anterolateral rotatory angulation of type IIA dens fracture fragment, and a type I Hangman fracture (Levine and Edwards classification). Nevertheless, the transverse atlantal ligament was intact. Interventions: We considered that the intact transverse atlantal ligament and kinking of the type IIA dens fracture fragment into the left lateral mass of C1 prevented a spinal cord injury by blocking a further displacement of C1 to C2. Due to the patient's osteoporosis and the anterolateral rotatory angulated type IIA dens fracture fragment, a forceful reduction of the atlantoaxial anteroinferior subluxation with kyphosis could pose a high risk of fixation failure and spinal cord injury. Therefore, we performed in-situ posterior C1-2 fusion using a C1 lateral mass screw and C2 lamina screw fixations. Outcomes: At 1 year after surgery, the bone union of all fractures was achieved in the kyphosis state. Furthermore, the patient's clinical symptoms were improved with no neurological deficit. Lessons: A thorough radiological examination and appropriate surgical strategy are important for successful diagnosis and treatment of a complex C1-2 injury.

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“… 11 12 13 14 15 In addition, few reports described cervical myelopathy resulting from degenerative or hypertrophic osteoarthritis of the C1-C2 joint. 16 17 18 19 20 21 22 To our knowledge, however, no study has reported cervical myelopathy caused by long-standing neglected traumatic posterior AOD and its late sequel involving the C0-C1-C2 joints. Therefore, in this report, we present a patient with cervical myelopathy caused by long-standing neglected posterior AOD and posttraumatic osteophytes of the C0-C1-C2 joints, which was successfully treated by laminectomy of the C1 posterior arch alone without occipitocervical fusion (OCF).…”

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confidence: 99%

Cervical Myelopathy Caused by Posttraumatic Osteophytes Resulting From Long-Standing Neglected Posterior Atlanto-Occipital Dislocation More Than 30 years: A Case Report

Chang¹,

Park²,

Park³

et al. 2021

JAAOS Glob Res Rev

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Introduction: Traumatic atlanto-occipital dislocation (AOD) is a rare but usually fatal injury. To our knowledge, no study has reported long-standing neglected posterior AOD more than 30 years in a patient who survived and later experienced cervical myelopathy. Methods: A 75-year-old man presented with symptoms of cervical myelopathy. On history, the patient was diagnosed with posterior AOD that occurred after a fall 31 years ago, but he did not undergo surgery. Radiologic evaluation of cervical spine revealed severe spinal cord compression caused by posttraumatic osteophytes of the C0-C1-C2 joints resulting from long-standing neglected posterior AOD. However, no instability of the C0-C1-C2 joints was found. Results: Laminectomy of the C1 posterior arch was performed without occipitocervical fusion considering the long-standing severe osteoarthritic changes and no instability of the C0-C1-C2 joints. Cervical myelopathy significantly improved, and the patient was doing well without recurrence at the 7-year follow-up. Discussion: To our knowledge, this is the first report of a patient with cervical myelopathy caused by neglected posterior AOD with posttraumatic osteophytes of the C0-C1-C2 joints. Laminectomy of the C1 posterior arch without occipitocervical fusion achieved satisfactory outcomes for cervical myelopathy caused by posttraumatic osteophytes resulting from long-standing neglected posterior AOD more than 30 years.

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Radiographic and Clinical Results of C1 Laminoplasty for the Treatment of Compressive Myelopathy

Cited by 8 publications

References 20 publications

A case of anterior arch fracture of the atlas associated with C1 laminectomy

A case of anterior arch fracture of the atlas associated with C1 laminectomy

Traumatic atlantoaxial anteroinferior subluxation with dens and Hangman fractures

Cervical Myelopathy Caused by Posttraumatic Osteophytes Resulting From Long-Standing Neglected Posterior Atlanto-Occipital Dislocation More Than 30 years: A Case Report

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