title: Congenital axis dysmorphism in a medieval skeleton : …secunda a vertendo epistropheus….
abstract: OBJECTIVE
  We describe here the axis dysmorphism that we observed in the skeletal remains of a human child dug up from a fifteenth century cemetery located in north-eastern Italy. This bone defect is discussed in the light of pertinent literature.
  
  
  METHODS
  We performed macroscopical examination and CT scan analysis of the axis.
  
  
  RESULTS
  Axis structure was remarkably asymmetric. Whilst the left half exhibited normal morphology, the right one was smaller than normal, and its lateral articular surface showed horizontal orientation. In addition, the odontoid process appeared leftward deviated and displayed a supplementary articular-like facet situated on the right side of its surface.
  
  
  CONCLUSIONS
  These findings suggest a diagnosis of unilateral irregular segmentation of atlas and axis, a rare dysmorphism dependent upon disturbances of notochordal development in early embryonic life. Likewise other malformations of the craniovertebral junction, this axis defect may alter the delicate mechanisms of upper neck movements and cause a complex series of clinical symptoms. This is an emblematic case whereby human skeletal remains may provide valuable information on the anatomical defects of craniovertebral junction.
authors: Department of Experimental and Clinical Medicine, Section of Human Anatomy, University of Udine, Piazzale Kolbe 3, Udine, Italy.
authors: Luciana
authors: L
authors: Travan
authors: Paola
authors: P
authors: Saccheri
authors: Francesco
authors: F
authors: Toso
authors: Enrico
authors: E
authors: Crivellato
mesh_terms: D001368:Axis, Cervical Vertebra / Q000002:abnormalities*; D001270:Cervical Atlas / Q000002:abnormalities; D002648:Child; D049668:History, 15th Century; D049691:History, Medieval; D006801:Humans; D007558:Italy; D009809:Odontoid Process / Q000002:abnormalities; D014057:Tomography, X-Ray Computed