title: Os odontoideum with bipartite atlas and segmental instability: a case report.
abstract: We report on the case of a 15-year-old adolescent who presented with a transient paraplegia and hyposensibility of the upper extremities after sustaining a minor hyperflexion trauma to the cervical spine. Neuroimaging studies revealed atlantoaxial dislocation and ventral compression of the rostral spinal cord with increased cord signal at C1/C2 levels caused by an os odontoideum, as well as anterior and posterior arch defects of the atlas. The patient underwent closed reduction and posterior atlantoaxial fusion. We describe the association of an acquired instability secondary to an os odontoideum with an anteroposterior spondyloschisis of the atlas and its functional result after 12 months. The rare coincidence of both lesions indicates a multiple malformation of the upper cervical spine and supports the theory of an embryologic genesis of os odontoideum.
authors.affiliation: Academic Hospital Feldkirch, Trauma Surgery and Sports Traumatology, Feldkirch, Austria. michael.osti@lkhf.at
authors.forename: Michael
authors.initials: M
authors.lastname: Osti
authors.forename: Helmut
authors.initials: H
authors.lastname: Philipp
authors.forename: Berthold
authors.initials: B
authors.lastname: Meusburger
authors.forename: Karl-Peter
authors.initials: KP
authors.lastname: Benedetto
mesh_terms: D000293:Adolescent; D001268:Atlanto-Axial Joint / Q000601:surgery; D001368:Axis, Cervical Vertebra; D001863:Bone Screws; D001864:Bone Wires; D001270:Cervical Atlas / Q000002:abnormalities*; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000175:diagnosis / Q000209:etiology; D007593:Joint Instability / Q000209:etiology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D009809:Odontoid Process / Q000002:abnormalities*; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000209:etiology; D013123:Spinal Fusion; D013124:Spinal Injuries / Q000150:complications; D014057:Tomography, X-Ray Computed