Burke Shane M, Huhta Taylor A, Mackel Charles E, Riesenburger Ron I
Department of Neurosurgery, Tufts Medical Center and Tufts University School of Medicine, Boston, Massachusetts, USA.
BMJ Case Rep. 2015 May 14;2015:bcr2015209623. doi: 10.1136/bcr-2015-209623.
Occipital condyle fractures and occipitalisation of the atlas are rare entities of the craniocervical junction. To the best of our knowledge, a patient presenting with a traumatic occipital condyle fracture and pre-existing occipitalisation of the atlas has not been previously reported. We report the case of a 79-year-old man presenting with an Anderson and Montesano type III fracture through a fused occipital condyle and lateral mass. This fracture was noted to extend into the transverse foramen and the C1-C2 joint space. The transverse ligament and ligamentum flavum were calcified but not disrupted and the atlantodental interval was within normal limits. The neurological examination was unremarkable with the exception of neck pain. The patient was treated conservatively and placed in a rigid cervical collar for 10 weeks with serial CT studies to monitor healing of the fracture. At 4 months of follow-up, the patient was pain free with nearly complete resolution of his occipital condyle fracture.
枕髁骨折和寰椎枕化是颅颈交界区的罕见病症。据我们所知，此前尚未报道过有患者同时存在创伤性枕髁骨折和既往存在的寰椎枕化。我们报告一例79岁男性患者，其Anderson和Montesano III型骨折通过融合的枕髁和侧块。该骨折延伸至横突孔和C1-C2关节间隙。横韧带和黄韧带钙化但未断裂，寰齿间距在正常范围内。除颈部疼痛外，神经系统检查无异常。患者接受保守治疗，佩戴硬质颈托10周，并进行系列CT检查以监测骨折愈合情况。在随访4个月时，患者疼痛消失，枕髁骨折几乎完全愈合。
