Okamoto K, Sumi M, Ikeda M, Sawamura S, Kataoka O
Department of Orthopedic Surgery, Kobe National Hospital.
Kobe J Med Sci. 1998 Jun;44(3):135-40.
The craniocervical junction is one of the most common sites of malformations. Only three cases of myelopathy due to hypoplasia of atlas have been reported previously. Among these malformations, the hypoplasia of atlas was first described by Wackenheim in 1974. Although developmental canal stenosis due to the hypoplasia of atlas seems to have a tendency of causing the cervical myelopathy, only three cases of cervical myelopathy due to this condition have been reported previously. A 77-year-old man with severe canal stenosis at the level of the atlas is reported. The clinical manifestations were 20-year history of progressive gait disturbance and paresis of both upper and lower extremities. The spinal cord was markedly compressed at the level of the atlas. The clinical manifestations improved after a resection of posterior arch of the atlas.
颅颈交界区是最常见的畸形部位之一。此前仅报道过3例因寰椎发育不全导致的脊髓病。在这些畸形中,寰椎发育不全最早由瓦肯海姆于1974年描述。尽管寰椎发育不全导致的发育性椎管狭窄似乎有引起颈髓病的倾向,但此前仅报道过3例因这种情况导致的颈髓病。本文报道了一名77岁男性,其寰椎水平存在严重的椎管狭窄。临床表现为有20年进行性步态障碍及双上肢和双下肢无力的病史。脊髓在寰椎水平明显受压。切除寰椎后弓后,临床表现有所改善。