Great Ormond Street Hospital for Sick Children, London, England.
Department of Paediatric Neurosurgery, Great Ormond Street Hospital for Children, London, England.
Eur Spine J. 2024 Mar;33(3):1164-1170. doi: 10.1007/s00586-023-08044-1. Epub 2023 Nov 23.
Os odontoideum refers to a rounded ossicle detached from a hypoplastic odontoid process at the body of the axis. The aetiology has been debated and believed to be either congenital or acquired (resulting from trauma). Os odontoideum results in incompetence of the transverse ligament and thus predisposes to atlantoaxial instability and spinal cord injury.
METHODS/RESULTS: Three cases of children with severe dystonic cerebral palsy presenting with myelopathic deterioration secondary to atlantoaxial instability due to os odontoideum are presented. This observation supports the hypothesis of os odontoideum being an acquired phenomenon, secondary to chronic excessive movement with damage to the developing odontoid process.
In children with cerebral palsy and dystonia, pre-existing motor deficits may conceal an evolving myelopathy and result in delayed diagnosis of clinically significant atlantoaxial subluxation.
齿状突骨是指从枢椎椎体上的发育不良的齿突游离出来的圆形骨块。其病因存在争议，被认为是先天性的或后天性的（由创伤引起）。齿状突骨会导致横韧带功能不全，从而容易导致寰枢椎不稳定和脊髓损伤。
方法/结果：本文介绍了 3 例严重痉挛性脑瘫儿童，由于齿状突骨导致寰枢椎不稳定而出现脊髓病恶化。这一观察结果支持齿状突骨是后天获得性疾病的假说，继发于慢性过度运动导致发育中的齿突过程受损。
在脑瘫和痉挛的儿童中，先前存在的运动缺陷可能会掩盖进行性的脊髓病，并导致临床上明显的寰枢椎半脱位的诊断延迟。
