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Song, Ham, Ko, and Lee: Stress Fracture of the Anterior Atlas Arch Following C1 Posterior Arch Resection for Cervical Myelopathy with Retro-Odontoid Pseudotumor
Case Report

Journal of the Korean Orthopaedic Association 2015; 50(5): 407-411.

Published online: 23 October 2015

DOI: https://doi.org/10.4055/jkoa.2015.50.5.407

Stress Fracture of the Anterior Atlas Arch Following C1 Posterior Arch Resection for Cervical Myelopathy with Retro-Odontoid Pseudotumor

Kyung-Jin Song, M.D., Dong-Hun Ham, M.D., Jong-Hyun Ko, M.D., Su-Kyung Lee, M.D.

Department of Orthopedic Surgery, Research Institute of Clinical Medicine, Chonbuk National University Medical School, Biomedical Science Institute, Chonbuk National University Hospital, Jeonju, Korea.

Correspondence to: Dong-Hun Ham, M.D. Department of Orthopedic Surgery, Chonbuk National University Medical School, 20 Geonji-ro, Deokjin-gu, Jeonju 54907, Korea. TEL: +82-63-250-1760, FAX: +82-63-271-6538, ham190@hanmail.net

Received 23 November 2014       Revised 5 April 2015       Accepted 15 May 2015

Copyright © 2015 by The Korean Orthopaedic Association

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Atlas fracture accounts for 1% to 3% of all spinal column injuries and 10% of cervical spine fractures, and is most frequently caused by motor vehicle accidents and falls. Only a few cases involving complications after surgical treatment have been reported. We present a case of anterior atlas arch stress fracture accompanied by worsening neurologic symptoms following atlas posterior arch resection for cervical myelopathy with retro-odontoid pseudotumor.

Keywords: cervical atlas, anterior arch, posterior arch, stress fracture

Figures and Tables

Figure 1

Lateral cervical radiographs showing severe degenerative spondylosis, kyphosis and instability at C1-C2. The atlanto-dental interval is 5 mm at flexion (A) and reduced at extension (B).

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Figure 2

The retro-odontoid pseudotumor and intramedullary hyper-intense lesion of C1 and C2 were observed in sagittal (A) and axial (B) images on T2-weighted magnetic resonance imaging.

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Figure 3

Computed tomography scans showing that C1 posterior arch resection was accomplished and that C1 anterior fracture occurred.

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Figure 4

No changes of the retro-odontoid pseudotumor and increased intramedullary hyper-intense lesion of C1 and C2 were observed in sagittal (A) and axial (B) images on T2-weighted magnetic resonance imaging.

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Figure 5

One year postoperative images (A: anteroposterior view, B: flexion view, C: extension view) showing adequate placement of the implants with good cervical alignment and successful posterior fusion compared with preoperative image (D).

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Notes

CONFLICTS OF INTEREST The authors have nothing to disclose.

References

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