Verska J M, Anderson P A
Department of Orthopaedic Surgery, University of Washington, Seattle, USA.
Spine (Phila Pa 1976). 1997 Mar 15;22(6):706-9. doi: 10.1097/00007632-199703150-00026.
This case report identifies one identical twin with an os odontoideum after trauma and the other twin with a normal cervical spine and no history of trauma.
To highlight the etiology of os odontoideum as posttraumatic as opposed to congenital in nature.
The etiology of os odontoideum has been debated since its original description by Giacomini in 1886. Although proponents of the congenital origin are supported by association with various congenital anomalies, including Down's syndrome, Klippel-Feil syndrome, and multiple epiphyseal dysplasia, the majority of reports suggest a posttraumatic etiology.
We reviewed the cervical radiographs of an identical twin with transient paresis and significant trauma to her neck as a child after a motor vehicle accident. The radiographs were compared with those of her twin sister, who had no history of trauma.
Os odontoideum was identified in one identical twin with a history of trauma. She was treated with a posterior C1-C2 arthrodesis using the Magerel transarticular screw technique supplemented by a modified Gallie's wiring. At a 12-month follow-up, she was asymptomatic and had a solid fusion based on flexion and extension views.
This case report of an os odontoideum occurring in one identical twin after a traumatic injury supports the possibility of a posttraumatic, as opposed to congenital, theory of origin.
本病例报告确定了一对同卵双胞胎，其中一人在创伤后出现齿突小骨，另一人颈椎正常且无创伤史。
强调齿突小骨的病因是创伤后形成而非先天性的。
自1886年贾科米尼首次描述齿突小骨以来，其病因一直存在争议。尽管先天性起源的支持者得到了与各种先天性异常（包括唐氏综合征、克利佩尔-费尔综合征和多发性骨骺发育不良）相关联的支持，但大多数报告表明其病因是创伤后形成的。
我们回顾了一名同卵双胞胎的颈椎X线片，该双胞胎在儿童时期发生机动车事故后颈部受到短暂性轻瘫和严重创伤。将这些X线片与她没有创伤史的双胞胎姐妹的X线片进行比较。
在有创伤史的一名同卵双胞胎中发现了齿突小骨。她接受了使用马热雷经关节螺钉技术并辅以改良的加里钢丝固定的后路C1-C2关节融合术。在12个月的随访中，她没有症状，根据屈伸位片显示融合牢固。
本病例报告中一名同卵双胞胎在创伤后出现齿突小骨，支持了创伤后起源理论而非先天性起源理论的可能性。
