Dorsal C1-2 Spinal Cord Compression After Reduction of Atlantoaxial Posterior Dislocation Associated With Os Odontoideum: A Case Report and Literature Review.
Jianzhi Wang, Jin Chen, Junhu Li et al.
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Case in brief
A 61-year-old man with progressive limb numbness, weakness, and incomplete quadriplegia was found to have chronic atlantoaxial posterior dislocation associated with os odontoideum and congenital atlas hypoplasia. After posterior C1-2 reduction and fixation, his neurological symptoms initially improved but then worsened due to dorsal C1-2 spinal cord compression. Emergency decompression led to rapid neurological recovery, and follow-up imaging showed maintained reduction and a patent spinal canal.
What made this case unusual
The case highlights the unexpected postoperative spinal cord compression despite satisfactory radiographic reduction, attributed to preexisting anatomical factors.
Diagnostic / clinical pearl
Clinicians should be aware that satisfactory imaging results post-reduction do not guarantee adequate spinal cord space, especially in cases with congenital anomalies.
Why it matters
This case underscores the importance of evaluating the postreduction canal space in patients with congenital atlas hypoplasia or osteophytes to prevent neurological deterioration.