FOAR: Facet Joint Osteoarthritis with Radiculopathy: A Case Series and a Hypothesis Explaining Spinal Nerve Irritation in the Absence of Osteodiskal Compression

Background:Atlantoaxial osteoarthritis (AAOA), either in isolation or in the context of generalized peripheral or spinal arthritis, presents most commonly with neck pain and limitation of cervical rotational range of motion. Occipital neuralgia (ON) is only rarely attributed to AAOA, as fewer than 30 cases are described in the literature.Case Description:A 64-year-old female presented with progressive incapacitating cervicalgia and occipital headaches, refractory to medications, and local anesthetic blocks. Computed tomography and magnetic resonance imaging studies documented advanced unilateral atlantoaxial arthrosis with osteophytic compression that dorsally displaced the associated C2 nerve root. Surgical decompression and atlantoaxial fusion achieved rapid and complete relief of neuralgia. Ultimately, postoperative spinal imaging revealed osseous union.Conclusions:Atlantoaxial arthrosis must be considered in the differential diagnosis of ON. Surgical treatment is effective for managing refractory cases. Intraoperative neuronavigation is also a useful adjunct to guide instrumentation and the intraoperative extent of bony decompression.

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“…reported on 1 case of ON secondary to AAOA, treated unsuccessfully with oral analgesia alone. [ 13 ]…”

Section: Discussionmentioning

confidence: 99%

Occipital neuralgia secondary to unilateral atlantoaxial osteoarthritis: Case report and review of the literature

et al. 2015

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Dynamic magnetic resonance imaging to demonstrate C2 radiculopathy secondary to atlantoaxial osteoarthritis causing occipital neuralgia: A case report

Fujimoto

Nishikawa²,

Tanioka

et al. 2021

Interdisciplinary Neurosurgery

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FOAR: Facet Joint Osteoarthritis with Radiculopathy: A Case Series and a Hypothesis Explaining Spinal Nerve Irritation in the Absence of Osteodiskal Compression

Cited by 2 publications

References 16 publications

Occipital neuralgia secondary to unilateral atlantoaxial osteoarthritis: Case report and review of the literature

Occipital neuralgia secondary to unilateral atlantoaxial osteoarthritis: Case report and review of the literature

Dynamic magnetic resonance imaging to demonstrate C2 radiculopathy secondary to atlantoaxial osteoarthritis causing occipital neuralgia: A case report

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