Choi Man Kyu, Kim Sung Bum, Lee Jun Ho
Department of Neurosurgery, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea.
J Korean Neurosurg Soc. 2021 Sep;64(5):837-842. doi: 10.3340/jkns.2020.0293. Epub 2021 Jul 28.
An atlantoaxial subluxation from the unstable Os odontoideum by the failure of proper integrations between the embryological somites might be a commonly reported pathology. However, its suspicious origin or paralleled occurrence with other congenital anomalies of vertebral body might be a relatively rare phenomenon. The authors present two cases, who simply presented with clinical signs of prolonged, intractable cervicalgia without any neurological deficits, revealed this rare feature of C1-2 subluxation from the unstable, orthotropic type of Os odontoideum that coincide with congenitally fused cervical vertebral bodies between C2-3. Surprisingly, in one case, when traced from the lower cervical down to the thoracic-lumbar levels during the preoperative work-up process, was also compromised with multi-level butterfly vertebrae formations. Presented cases highlight the association of various congenital vertebrae anomalies and the rationale to fuse only affected joints.
胚胎体节之间正常整合失败导致不稳定的齿状突引起的寰枢椎半脱位可能是一种常见报道的病理情况。然而,其可疑的起源或与椎体其他先天性异常同时出现可能是一种相对罕见的现象。作者报告了两例患者,他们仅表现为长期顽固性颈痛的临床症状,无任何神经功能缺损,揭示了这种来自不稳定、正交型齿状突的C1-2半脱位的罕见特征,且与C2-3之间先天性融合的颈椎椎体相吻合。令人惊讶的是,在一例患者中,术前检查过程中从下颈椎追踪至胸腰段时,还伴有多节段蝴蝶椎形成。所报告的病例突出了各种先天性椎体异常之间的关联以及仅融合受影响关节的基本原理。