Document Detail

Cervical myelopathy caused by pseudoarthrosis between posterior arch of the atlas and lamina of the axis in Klippel-Feil syndrome: a case report.
MedLine Citation:
PMID:  18458595     Owner:  NLM     Status:  MEDLINE    
STUDY DESIGN: Case report. SUMMARY OF BACKGROUND DATA: Cervical myelopathy caused by osteophyte formation appearing at the pseudoarthrosis between the posterior arch of the atlas and the lamina of the axis is extremely rare. To our knowledge, only 2 cases in non-Klippel-Feil syndrome have been reported so far. METHODS: A 61-year-old man, who was diagnosed as Klippel-Feil syndrome with assimilation between C2 and C3 vertebrae, which were fused in hyperlordosis, suffered cervical myelopathy. Complete bipartition of the atlas was also demonstrated. Massive osteophytes, which severely compressed the spinal cord at the pseudoarthrosis between the posterior arch of the atlas and the lamina of the axis, were seen. Surgical resection of the osteophytes was performed. RESULTS: The patient had significant clinical improvement after posterior resection of the osteophytes. CONCLUSIONS: Coincidence of several bony anomalies such as assimilation of C2 and C3, which were fused in hyperlordosis, and the bipartition of the atlas may biomechanically influence the formation of pseudoarthrosis between the posterior arch of the atlas and the lamina of the axis. Because symptoms appeared in the patient's 60s despite congenital bony anomaly, degeneration might contribute to the formation of massive osteophytes. Posterior decompression was effective in this case.
Teppei Suzuki; Hiroshi Miyamoto; Masatoshi Sumi; Yoshihiro Inui; Koki Uno; Masato Takabatake; Kou Tadokoro
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of spinal disorders & techniques     Volume:  21     ISSN:  1536-0652     ISO Abbreviation:  J Spinal Disord Tech     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-06     Completed Date:  2008-07-01     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  101140323     Medline TA:  J Spinal Disord Tech     Country:  United States    
Other Details:
Languages:  eng     Pagination:  225-8     Citation Subset:  IM    
Department of Orthopedic Surgery, National Hospital Organization Kobe Medical Center, Kobe, Japan.
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MeSH Terms
Axis / surgery
Cervical Atlas / surgery
Klippel-Feil Syndrome / complications*
Magnetic Resonance Imaging
Middle Aged
Pseudarthrosis / complications*,  diagnosis
Spinal Cord Diseases / diagnosis,  etiology*

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