Cervical Myelopathy Caused by Posttraumatic Osteophytes Resulting From Long-Standing Neglected Posterior Atlanto-Occipital Dislocation More Than 30 years: A Case Report.

J Am Acad Orthop Surg Glob Res Rev

From the Department of Orthopaedic Surgery, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea (Dr. Chang and Dr. Kim), and the Department of Orthopaedic Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea (Dr. J.-B. Park and S.-B. Park).

Published: October 2021

Introduction: Traumatic atlanto-occipital dislocation (AOD) is a rare but usually fatal injury. To our knowledge, no study has reported long-standing neglected posterior AOD more than 30 years in a patient who survived and later experienced cervical myelopathy.

Methods: A 75-year-old man presented with symptoms of cervical myelopathy. On history, the patient was diagnosed with posterior AOD that occurred after a fall 31 years ago, but he did not undergo surgery. Radiologic evaluation of cervical spine revealed severe spinal cord compression caused by posttraumatic osteophytes of the C0-C1-C2 joints resulting from long-standing neglected posterior AOD. However, no instability of the C0-C1-C2 joints was found.

Results: Laminectomy of the C1 posterior arch was performed without occipitocervical fusion considering the long-standing severe osteoarthritic changes and no instability of the C0-C1-C2 joints. Cervical myelopathy significantly improved, and the patient was doing well without recurrence at the 7-year follow-up.

Discussion: To our knowledge, this is the first report of a patient with cervical myelopathy caused by neglected posterior AOD with posttraumatic osteophytes of the C0-C1-C2 joints. Laminectomy of the C1 posterior arch without occipitocervical fusion achieved satisfactory outcomes for cervical myelopathy caused by posttraumatic osteophytes resulting from long-standing neglected posterior AOD more than 30 years.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8492371PMC
http://dx.doi.org/10.5435/JAAOSGlobal-D-21-00129DOI Listing

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