A rare case of cervical myelopathy caused by invaginated laminae of the axis into the spinal canal

Zhu, Ce; Zhou, Bangjian; Liu, Limin; Song, Yueming

doi:10.1016/j.spinee.2016.02.005

Cited by 1 publication

(3 citation statements)

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“…Only 8 cases (Table 1 ) caused by an invaginated anomalous laminae of the axis have been reported. [ 5 – 12 ] Compared with this type of malformation of axis, the dysplasias of the atlas are much more varied and common, such as occipitalization of the atlas. The incidence of congenital atlanto-occipital fusion ranges from 0.14% to 0.75%.…”

Section: Discussionmentioning

confidence: 99%

“…[ 14 – 17 ] The pathogenesis in present case, however, has not been well explained by previous scholars. [ 5 – 12 ] We assume that the 4 posterior chondrification centers fail to fuse into 2 ossification centers bilaterally, but fuse into 3 ossification centers in the early stage. Then each of the 3 ossification centers develops individually instead of fusion to a whole laminae, which leads to the current anomaly (Fig.…”

Section: Discussionmentioning

confidence: 99%

“…All the 9 patients received decompressive surgery by removal of the anomalous bony structure with a favorable outcome. [ 5 – 12 ] Whether to choose an internal fixation/fusion depended on segmental stability, age, patient's expectation, and so on. We fused C2 and C3 instead of fusion to C1 or C0.…”

Section: Discussionmentioning

confidence: 99%

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Cervical myelopathy caused by invaginated laminae of the axis associated with occipitalizaion of the atlas

Wang²,

Zhou³

et al. 2017

Medicine

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Rationale:In previous studies, few cases of cervical myelopathy caused by invaginated anomalous laminae of the axis have been reported, and none of them was combined with occipitalization of the atlas.Patient concerns:A 28-year-old male was brought to our hospital with motor and sensory impairments of the extremities after a car accident.Diagnoses:MRI showed the spinal cord was markedly compressed at the C2/3 level. Reconstructed CT scans revealed an invaginated laminae of axis into the spinal canal as well as atlas assimilation.Interventions:The patient was successfully managed with surgical treatment by removal of the anomalous osseous structure as well as fixation and fusion.Outcomes:The patient had a rapid recovery after the operation. He regained the normal strength of his 4 extremities and the numbness of his extremities disappeared. He returned to his normal work 3 months after the surgery without any symptoms.Lessons:Invaginated laminae of axis combined with occipitalization of the atlas is a rare deformity. MRI and reconstructed CT scans are useful for both diagnosing and surgical planning of this case. Surgical removal of the laminae results in a satisfactory outcome. The pathogenesis of this anomaly could be the fusion sequence error of the 4 chondrification centers in the embryological term.

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Section: Discussionmentioning

confidence: 99%