Anterior atlas fracture following suboccipital decompression for Chiari I malformation. Report of two cases.
Chiari I malformation, a congenital disorder involving downward displacement of the cerebellar tonsils through the foramen magnum, is often treated surgically by performing suboccipital craniectomy and C-1 laminectomy. The authors report two cases in which fracture of the anterior atlantal arch occurred during the postoperative period following Chiari I decompression and C-1 laminectomy causing significant neck pain. The findings indicate that interruption of the integrity of the posterior arch of C-1, iatrogenically or otherwise, confers increased risk of anterior arch fracture. A C-1 fracture should therefore be considered in the differential diagnosis of posterior cervical pain in patients who have previously undergone decompression for Chiari I malformation.
O'Shaughnessy
Brian A
BA
Department of Neurological Surgery, The Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Salehi
Sean A
SA
Ali
Saad
S
Liu
John C
JC
D000293:Adolescent; D001139:Arnold-Chiari Malformation / Q000473:pathology / Q000601:surgery*; D001270:Cervical Atlas / Q000293:injuries* / Q000473:pathology / Q000601:surgery*; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000473:pathology; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011183:Postoperative Complications; D016103:Spinal Fractures / Q000209:etiology* / Q000473:pathology