Cervical myelopathy and congenital stenosis from hypoplasia of the atlas: report of three cases and literature review

Abstract

Study design: Case reports of patients with cervical myelopathy to hypoplasia of the atlas.

Objectives: To report cases of cervical myelopathy due to congenital hypoplasia of the atlas and to review the literature.

Summary of background data: Six previously documented cases of congenital hypoplasia of the atlas as a cause of cervical myelopathy are reported in the literature.

Methods: Three patient's clinical record and radiologic imaging studies as well as a thorough literature search are reported. Plain radiographs, computed tomography scans, magnetic resonance images, as well as somatosensory-evoked potential changes are displayed.

Results: Cervical myelopathy developed in three patients who were found to have congenital hypoplasia of the atlas. Laminectomy of C1 provided neurologic improvement in all three patients presented.

Conclusion: Congenital hypoplasia of the atlas is a rare cause of cervical myelopathy. This report should broaden the radiographic differential diagnosis when seeking an explanation for the signs and symptoms of cervical myelopathy.