Ogata Tadanori, Morino Tadao, Hino Masayuki, Miura Hiromasa
Spine Center, Ehime University Hospital, Tohon-city, Ehime, 791-0295, Japan.
J Med Case Rep. 2012 Jun 28;6:171. doi: 10.1186/1752-1947-6-171.
Congenital hypoplasia of the atlas has rarely been reported. Myelopathy caused by the complete absence of the posterior arch of the atlas has not been reported. This case report describes the diagnosis and successful treatment of a myelopathy due to the complete absence of the posterior arch of the atlas.
A 59-year-old Japanese man experienced pain in his nuchal region with progressive spasticity, numbness and hypesthesia in his upper and lower limbs. Deep tendon reflexes in his upper and lower limbs were increased. The complete absence of the posterior arch of the atlas and atlantoaxial instability were found in a roentgenogram. Magnetic resonance imaging detected high signal intensity on T2-weighted images in his spinal cord at the level of cervical vertebrae 1 to 2. Our patient underwent posterior occipito-C4 fixation with pedicle screws. After the operation, the pain in his nuchal region disappeared and his symptoms of myelopathy improved. Only slight numbness of his upper limbs remained.
This is the first report of myelopathy due to the complete absence of the posterior arch of the atlas.
寰椎先天性发育不全鲜有报道。寰椎后弓完全缺如导致的脊髓病尚未见报道。本病例报告描述了一例因寰椎后弓完全缺如所致脊髓病的诊断及成功治疗。
一名59岁日本男性，颈部疼痛，上肢和下肢逐渐出现痉挛、麻木及感觉减退。上下肢的深腱反射亢进。X线片显示寰椎后弓完全缺如及寰枢椎不稳。磁共振成像在颈椎1至2水平脊髓的T2加权图像上检测到高信号强度。该患者接受了后路枕骨至C4椎弓根螺钉固定术。术后，其颈部疼痛消失，脊髓病症状改善。仅上肢仍有轻微麻木。
这是首例关于寰椎后弓完全缺如所致脊髓病的报告。
