Bipartite atlas mimicking traumatic atlantoaxial instability following a rugby tackle

Abstract

We report a very rare case of a congenital cervical spine anomaly. The low occurrence rate of this anatomic variant combined with the high frequency of cervical injuries in sports medicine made this case a diagnostic challenge on both emergency and orthopaedic departments. After reading, it should give the clinician a more consistent view in differentiating the traumatic or congenital origin of the disorder seen on radiographs, as well as what can be expected in the future when diagnosis is set.

Bipartite Atlas in a collegiate football player - Not necessarily a contraindication for return-to-play: A case report and review of the literature

“…chose to recommend that their patient refrain from further participation in contact sports and to “adjust his recreational activities;” however, the authors acknowledged a lack of hard evidence on which this decision was based. [11] Of note, the patient in that case report had no studies demonstrating any evidence of instability. [11]…”

“…A few other reports have been described in the setting of athletic participation. [411] One of the reports made no mention of return-to-play recommendations, but noted that the football player was treated symptomatically and ultimately remained asymptomatic. [4] Jans et al .…”

“…[11] Of note, the patient in that case report had no studies demonstrating any evidence of instability. [11]…”

“…Clefts or aplasia of the anterior and posterior arches of the atlas are well documented, but occur rarely. [13–81011141519212228] The prevalence of congenital malformations of the posterior arch of the atlas can range from 4 to 5% of the population. [1921] Anterior arch aplasia is extremely rare, occurring in approximately 0.1% of the population, and often only coexists with posterior arch anomalies.…”

“…[1921] Also referred to as “bipartite atlas,” the prevalence of combined anterior and posterior defects is uncertain. [11] Cases of combined anterior and posterior clefts of atlas are either asymptomatic or have minimum symptoms, with most found incidentally on imaging studies performed for other indications. [410]…”