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Review
. 2012 Mar;35(2):125-7.
doi: 10.1179/1079026812Z.00000000023.

Cervical instability presenting as thoracic pain: case report and literature review

Benjamin M Zussman  1 , Nelson S Saldua, James S Harrop
Affiliations
Review

Cervical instability presenting as thoracic pain: case report and literature review

Benjamin M Zussman et al. J Spinal Cord Med. 2012 Mar.

Abstract

Study design: Case report.

Objective: To report a case of cervical instability from an os odontoideum that presented as posterior thoracic pain and to present a review of the literature.

Background: Thoracic posterior paraspinal spasms and pain are common chief complaints in individuals with spinal abnormalities.

Methods: A 19-year-old man presented with posterior thoracic pain for nearly 1 year following a college sports-related injury (lacrosse). Computed tomography and magnetic resonance imaging did not reveal any significant thoracic or lumbar spinal cord or nerve root pathology, but did reveal an incidental finding of an os odontoideum.

Results: Surgical stabilization of the atlantoaxial instability resulting from the os odontoideum resulted in complete resolution of the patient's thoracic pain.

Conclusions: Thoracic back pain without a clear thoracic spine etiology warrants further workup to rule out the possibility of spinal instability.

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Figures

Figure 1
Figure 1
Posterior C1–C2 instrumented fusion (C2 pars and C1 lateral mass). Follow-up radiographs at 3 months post-operation showed a solid fusion. Note os odontoideum with sclerotic margin (arrow).
See this image and copyright information in PMC

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