Marked canal stenosis at the level of the atlas

Abstract

A 38-year-old man with severe canal stenosis at the level of the atlas is reported. The clinical manifestations were muscular weakness and wasting of the upper limbs and spastic paresis of the lower limbs, which all progressed slowly. The atlas was hypoplastic and its retrodental space was narrow. The spinal cord was markedly compressed between the odontoid process and the posterior arch of the atlas. The clinical manifestations improved after a posterior laminectomy of the atlas.

Cervical Myelopathy Caused by Hypoplasia of the Atlas and Ossification of the Transverse Ligament. Case Report.

“…9,[11][12][13][14]16,18,21,24,27) Interestingly, all 13 known cases, including the present case, occurred in individuals of Asian origin (10 Japanese, 2 Chinese, 1 unknown). OPLL commonly occurs in the Japanese population, so the ethnic association is very important for this pathology.…”

“…Non-traumatic cervical myelopathy caused by canal stenosis at the level of the atlas is extremely rare, with only 12 reported cases. 9,[11][12][13][14]16,18,21,24,27) Ossification of the vertebral ligaments, most commonly the posterior longitudinal ligament (OPLL), frequently occurs in the Japanese population. 15) However, symptomatic ossification of the transverse ligament is extremely rare.…”

Atlas Hypoplasia Manifesting as Myelopathy in a Child. Case Report.

“…3,4,6,[8][9][10][11][12][13] All patients had myelopathic symptoms, except for one of unknown age and sex who had occipital neuralgia. 12) The patients were aged 38, 54, 55, 69, 73, 75, 77, 80, and 81 years.…”

“…4,13) All reported cases, including ours, involving atlas stenosis with a complete posterior arch occurred in Asian people, predominantly in men, indicative of ethnic association and sex dominance. 3,4,6,[8][9][10][11]13) The cases of brothers with atlas hypoplasia suggested a genetic factor. 9) Our case shows that myelopathy may be evoked even in a young patient with atlas hypoplasia with complete posterior arch and in the absence of spondylotic change.…”

“…Atlas hypoplasia with complete posterior arch is a rare congenital abnormality, exclusively occurring in Asian people, 3,4,6,[8][9][10][11]13) except for one case the details of which are unknown. 12) Clinical manifestation characteristically occurs late in adulthood when cervical spondylotic changes become apparent.…”