Treatment strategies for severe C1C2 luxation due to congenital os odontoideum causing tetraplegia

Bach, Christian; Arbab, Dariusch; Thaler, Martin

doi:10.1007/s00586-012-2329-5

Cited by 10 publications

(6 citation statements)

References 21 publications

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“…In posterior subluxation the os odontoideum and C1 are translating posteriorly into the spinal canal during extension. Anterolisthesis seems to be more often; however, some patients have instability in both directions 2)…”

Section: Discussionmentioning

confidence: 94%

What Causes Severe Myelopathy Resulting in Acute Quadriplegia after a Surgery for Atlantoaxial Subluxation due to Os Odontoideum? A Case Report

Paeng

2019

Korean J Neurotrauma

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A case of acute quadriplegia resulting from reduction of atlantoaxial subluxation due to os odontoideum is rare. Patient with os odontoideum are at a greater risk for atlantoaxial instability and resultant spinal cord compression. In our case, the patient exhibited mild myelopathic symptoms before the onset of acute quadriplegia. Owing to the clinical presentations, the spinal cord not only seemed to suffer a mechanical compression but also an insufﬁciency of blood supply to the spinal artery and its branches. No other report has described the findings from magnetic resonance imaging before and after the onset of acute myelopathy after surgery. The aim of our case report is to highlight the pathophysiology and appropriate management strategy of a patient with severe progressive spinal cord myelopathy after surgery, secondary to chronic atlantoaxial subluxation due to os odontoideum. This case depicts the presence of this rare yet possible complication, and emphasizes the importance of preoperative evaluation in cases with chronic progressive myelopathy. Moreover, urgent postoperative treatment and rehabilitation are important for the recovery of neurological symptoms.

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Section: Discussionmentioning

confidence: 94%

What Causes Severe Myelopathy Resulting in Acute Quadriplegia after a Surgery for Atlantoaxial Subluxation due to Os Odontoideum? A Case Report

Paeng

2019

Korean J Neurotrauma

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“…Loss of respiratory drive was thought to have occurred due to cervicomedullary compression as a result of the instability [21]. In our review, Patient 4 had C1-C2 instability that was misdiagnosed as an intramedullary spinal cord tumor due to compression [8].…”

Section: Discussionmentioning

confidence: 97%

Treatment of os odontoideum in a patient with spastic quadriplegic cerebral palsy

Akpolat

Fegale

Cheng

2015

Journal of Clinical Neuroscience

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“…The axis is formed from dens, caudal sclerotome of C2 and rostral sclerotome of C3. Os odontoideum, representive dysplasia of axis, occurs as a result of fusion failure between dens and C2 sclerotome [3,5-8]. Case 1 was considered to be fusion failure of axis body between C2 and C3 sclerotomes.…”

Section: Discussionmentioning

confidence: 99%

The Transspinal Canal Screwing Technique for Atlantoaxial Anomalies: A Technical Note and 2 Case Reports

Takebayashi¹,

Kubota²,

Yuzurihara³

et al. 2019

Neurospine

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It is difficult to treat atlantoaxial instability in patients with a high-riding vertebral artery or anomalies of the craniocervical junction. We report 2 successful cases in which the transspinal canal screwing technique was used because of difficulties performing conventional fixation methods. Case 1: A 78-year-old woman suffered from progressive myelopathy due to severe spinal cord compression with a congenital anomaly of the craniovertebral junction. Bilateral transspinal canal screws from the axis body with spondylolisthesis to the dens were inserted by retracting the dural sac medially after foramen magnum decompression and cervical laminoplasty. Case 2: A 20-year-old man with a spinal deformity due to Loeys-Dietz syndrome presented to our hospital for treatment of syringomyelia. He had no obvious neurological deficits, but spinal cord compression due to right atlantoaxial rotating dislocation was observed. A screw was inserted from the vertebral body of the axis to the right lateral mass of the atlas via the spinal canal after laminectomy of the atlas. The transspinal canal screwing technique is useful for treating atlantoaxial instability in cases where other fixation methods are difficult.

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Treatment strategies for severe C1C2 luxation due to congenital os odontoideum causing tetraplegia

Abstract: Treatment of severe C1C2 luxation is difficult with limited evidence in the literature. The current case shows a successful treatment strategy to reduce the deformity and lists alternative approaches.

Cited by 10 publications

References 21 publications

What Causes Severe Myelopathy Resulting in Acute Quadriplegia after a Surgery for Atlantoaxial Subluxation due to Os Odontoideum? A Case Report

What Causes Severe Myelopathy Resulting in Acute Quadriplegia after a Surgery for Atlantoaxial Subluxation due to Os Odontoideum? A Case Report

Treatment of os odontoideum in a patient with spastic quadriplegic cerebral palsy

The Transspinal Canal Screwing Technique for Atlantoaxial Anomalies: A Technical Note and 2 Case Reports

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