Os odontoideum: chronic neck pain after car accident; failure of two posterior atlantoaxial arthrodeses--medicolegal issues in the occupational setting.
نویسنده
چکیده
OBJECTIVE To present the case of a woman with previously asymptomatic os odontoideum (OO) who developed chronic neck pain after a car accident. CLINICAL FEATURES A 32-yr-old woman developed slight constant neck pain following a car accident. Radiographs revealed OO with 12-mm atlantoaxial subluxation on neck flexion. There was no spinal cord compression clinically or on magnetic resonance imaging. INTERVENTION AND OUTCOME Posterior atlantoaxial arthrodesis was performed twice but the bone graft resorbed for no apparent reason. The patient was treated with analgesics, physiotherapy and a Philadelphia collar to prevent accidental spinal cord compression. CONCLUSION OO patients may remain asymptomatic if "space available for cord" is sufficient. Even low velocity rotational injury can precipitate chronic neck pain in adults with OO. Posterior atlantoaxial arthrodesis can fail inexplicably even under the best circumstances. Medicolegal issues in the occupational setting are discussed.
منابع مشابه
Transoral approach for revision surgery of os odontoideum with atlantoaxial dislocation.
Revision surgery for os odontoideum with irreducible atlantoaxial dislocation with a transoral approach is not commonly seen. Typically, management of this type of atlantoaxial dislocation is through posterior fixation and fusion or transoral decompression and posterior fusion. This report describes revision surgery in a patient with os odontoideum who was treated with a transoral approach. A 5...
متن کاملOssification of the posterior atlantoaxial membrane associated with an os odontoideum: a case report.
We report a case of ossification of the posterior atlantoaxial membrane associated with an os odontoideum in a 46-year-old woman. She developed myelopathy following a minor motor vehicle accident. The patient underwent posterior atlantoaxial arthrodesis and resection of the ossified lesion and recovered uneventfully. Long-standing atlantoaxial instability might have played a role in ectopic oss...
متن کاملOs-odontoideum leading to atlanto-axial instability--report of surgery in four cases.
Os odontoideum can lead to atlantoaxial instability, which can be either reducible or a fixed dislocation. We present surgical management in four patients with os odontoideum at our center. Two of these had reducible dislocations and were managed by posterior transarticular screw fixation. Other two had fixed dislocations necessitating posterior decompression and occipitocervical fixation.
متن کاملAn uncommon case mimicking cervical trauma: Os odontoideum
Os odontoideum is a separate odontoid process from the body of the axis. It is the most common anomaly of the odontoid process. Patients with this condition can be asymptomatic or present with a wide range of neurological dysfunctions. It may cause cervical instability, atlantoaxial dislocation and myelopathy. This anomaly can mimic Type I and II odontoid fractures. There is a role for conserva...
متن کاملDens fracture or odontoid bone
Introduction During the embryological development the axis is formed from the proatlas, the C1 sclerotome and the C2 sclerotome. Failure of the odontoid process (C1 sclerotome) to fuse with the body of the axis (C2 sclerotome), or failure of the apex of the odontoid process (proatlas) to fuse with the main portion of the odontoid process has been advocated. The etiology of os odontoideum remain...
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عنوان ژورنال:
- Journal of manipulative and physiological therapeutics
دوره 16 7 شماره
صفحات -
تاریخ انتشار 1993