AI Article Synopsis
- Cervical spondylolysis is a rare condition typically found at the C-6 level, and this case involved a 57-year-old woman experiencing myelopathy due to congenital spondylolysis of the axis.
- Plain X-rays showed a defect in the axis pedicle, but advanced imaging techniques did not reveal spinal cord compression until the patient rotated her neck, which caused the spinal cord to be pinched.
- This case marks the 15th documented instance of axial spondylolysis and is unique as it links myelopathy to this specific mechanical injury mechanism, with no prior similar instances reported in the literature.
Article Abstract
Cervical spondylolysis is a rare clinical entity and occurs predominantly at the C-6 level. The authors describe a patient with congenital spondylolysis of the axis that caused myelopathy. The patient was a 57-year-old woman with long-standing gait disturbance. Plain cervical radiography revealed a radiolucent defect across the pedicle of the axis. Magnetic resonance imaging of the cervical spine in the neutral, flexion, and extension neck positions as well as a computerized tomography myelography in the neutral neck position failed to demonstrate any spinal cord compression. When she rotated her neck, however, the spinal cord was caught between the hypertrophic anterior arch of the atlas and posterior part of the slipped pedicle of the axis on the contralateral side. The spinal cord was transformed into a pear shape. Mechanical injury to the spinal cord seemed to explain her neurological presentation. This is, to the authors' knowledge, the 15th case of axial spondylolysis and the sixth case of spinal cord involvement of the cervical spondylolysis. No cases involving myelopathy secondary to such a unique mechanism have been reported previously in the literature.
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| http://dx.doi.org/10.3171/spi.2003.98.1.0084 | DOI Listing |
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