Aggarwal Rishi Anil, Srivastava Sudhir, Bhosale Sunil, Roy Kunal
Department of Orthopaedics, Seth G.S. Medical College and K.E.M. Hospital, Parel, Mumbai, Maharashtra, India.
JBJS Case Connect. 2016 Jul-Sep;6(3):e56. doi: 10.2106/JBJS.CC.15.00261.
A 55-year-old woman presented with chronic neck pain. Physical and neurological examination results were normal. Radiographs revealed absence of the posterior elements of C2 with hypertrophy of the spinous process of C3. A computed tomography scan showed occipitalization of the atlas with basilar invagination. Magnetic resonance imaging did not reveal any soft-tissue abnormalities. The patient was treated with a short course of a nonsteroidal anti-inflammatory drug and physiotherapy.
Agenesis of the posterior elements of C2 should be considered in patients with hypertrophy of the spinous process of C3. Patients may have a varied presentation ranging from neck pain to myelopathy. Dynamic (flexion and extension) lateral cervical spine radiographs should be obtained, as cases reported in the literature involved instability of the cervical spine.
一名55岁女性因慢性颈部疼痛就诊。体格检查和神经学检查结果均正常。X线片显示C2后部结构缺如，C3棘突肥大。计算机断层扫描显示寰椎枕化并伴有基底凹陷。磁共振成像未发现任何软组织异常。该患者接受了短期非甾体抗炎药治疗及物理治疗。
C3棘突肥大的患者应考虑C2后部结构发育不全。患者的表现可能多种多样，从颈部疼痛到脊髓病。应获取颈椎动态（屈伸）侧位X线片，因为文献报道的病例涉及颈椎不稳定。
