Castaño-Duque C H, Rivas-García A, Pons-Irazazabal L C, López-Moreno J L
Servicio de Radiodiagnóstico, Ciudad Sanitaria y Universitaria de Bellvitge, Barcelona, España.
Rev Neurol. 1997 Dec;25(148):1928-31.
Congenital abnormalities of the posterior arch of the atlas (C-1) are very uncommon and not widely known. Isolated partial agenesis of the posterior arch of the atlas was initially considered a benign variation without any clinical or pathological significance. There is, however, increasing evidence that neurological symptoms may occur after minor cervical trauma in patients with an isolated partial agenesis of the posterior arch of the atlas, specially the types 'C' and 'D' malformations described by Currarino et al.
A 63 year old woman with cervicalgia and 'seasickness', was study with a plain cervical spine radiographs and CT with three-dimensional reconstruction, who showed a bilateral partial absence of the posterior arch of C-1 with persistent posterior tubercle, corresponded to type 'D' in the classification descrites by Currarino et al.
The fact of this pathology can unchain an important neurological symptoms after minor cervical trauma, oblige to the physician (radiologist, neurologist, neurosurgeon, traumatologist, rehabilitation specialist) know this pathology, for to include this patients in a group of the risk, and indicate to them who should avoid contact sports and other strenuous athletic endeavors, and furthermore value the surgical treatment.
寰椎(C-1)后弓先天性异常非常罕见,并不广为人知。孤立性寰椎后弓部分发育不全最初被认为是一种无任何临床或病理意义的良性变异。然而,越来越多的证据表明,患有孤立性寰椎后弓部分发育不全的患者在轻微颈部创伤后可能会出现神经症状,特别是Currarino等人描述的“C”型和“D”型畸形。
一名63岁患有颈部疼痛和“晕船”症状的女性接受了颈椎X线平片和CT三维重建检查,结果显示C-1双侧后弓部分缺如,后结节持续存在,符合Currarino等人描述的分类中的“D”型。
这种病理情况在轻微颈部创伤后可能引发重要的神经症状,这要求医生(放射科医生、神经科医生、神经外科医生、创伤科医生、康复专家)了解这种病理情况,以便将这些患者纳入风险人群,并告知他们应避免接触性运动和其他剧烈体育活动,此外还要评估手术治疗的价值。