title: Compression Myelopathy due to Proliferative Changes around C2 Pars Defects without Instability.
abstract: We report a case with compression myelopathy due to proliferative changes around the C2 pars defects without instability. A 69-year-old man presented with progressive clumsy hands and spastic gait. Plain radiographs showed bilateral spondylolysis (pars defects) at C2 and fusion between C2 and C3 spinous processes. Dynamic views revealed mobility through the pars defects, but there was no apparent instability. Computed tomography showed proliferative changes at the pars defects, which protruded into spinal canal. On magnetic resonance imaging, the spinal cord was compressed and intramedullary high signal change was found. A diagnosis of compression myelopathy due to proliferative changes around the C2 pars defects was made. We performed posterior decompression. Postoperatively, symptoms have been alleviated and images revealed sufficient decompression and no apparent instability. In patients with the cervical spondylolysis, myelopathy caused by instability or slippage have been periodically reported. The present case involving C2 spondylolysis is extremely rare.
authors.affiliation: Department of Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, Kuramoto, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kimura
authors.affiliation: Department of Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, Kuramoto, Japan.
authors.forename: Toshinori
authors.initials: T
authors.lastname: Sakai
authors.affiliation: Department of Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, Kuramoto, Japan.
authors.forename: Fumitake
authors.initials: F
authors.lastname: Tezuka
authors.affiliation: Department of Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, Kuramoto, Japan.
authors.forename: Mitsunobu
authors.initials: M
authors.lastname: Abe
authors.affiliation: Department of Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, Kuramoto, Japan.
authors.forename: Kazuta
authors.initials: K
authors.lastname: Yamashita
authors.affiliation: Department of Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, Kuramoto, Japan.
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Takata
authors.affiliation: Department of Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, Kuramoto, Japan.
authors.forename: Kosaku
authors.initials: K
authors.lastname: Higashino
authors.affiliation: Department of Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, Kuramoto, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Sairyo
keywords: Axis; Cervical vertebra; Spinal cord compression; Spondylolysis