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. 2013 Sep;10(3):189-91.
doi: 10.14245/kjs.2013.10.3.189. Epub 2013 Sep 30.

Cervical Myelopathy Secondary to Atlanto-occipital Assimilation: The Usefulness of the Simple Decompressive Surgery

Kang Rae Kim  1 , Young Min Lee  1 , Young Zoon Kim  1 , Yong Woon Cho  1 , Joon Soo Kim  1 , Kyu Hong Kim  1 , In Chang Lee  1
Affiliations

Cervical Myelopathy Secondary to Atlanto-occipital Assimilation: The Usefulness of the Simple Decompressive Surgery

Kang Rae Kim et al. Korean J Spine. 2013 Sep.

Abstract

Atlanto-occipital assimilation is one of the most common osseous anomalies observed at the craniocervical junction. Most patients with atlas assimilation show no symptom, but some have neurological problems such as myelopathy that may require surgical treatment. Occipitocervical fusion may be required if atlato-occipital assimilation is accompanied by occipito-axial instability. However, in cases of symptomatic atlas assimilation with minor cord compression without instability, simple decompressive surgery may be the treatment modality. This report describes a case of successful treatment of a patient with myelopathy secondary to atlanto-occipital assimilation without instability, using posterior simple decompressive surgery.

Keywords: Assimilation; Atlanto-occipital joint; Decompression; Myelopathy.

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Figures

Fig. 1
Fig. 1
Preoperative lateral radiograph (A), sagittal, left side (B), axial (C) and 3-demensional (3D) (D) computed tomography reveal atlanto-occipital assmilation, thecal sac compression by C1, 2 posterior arch encroachment (arrow) and C2-3 fusion on posterior element.
Fig. 2
Fig. 2
Sagittal (A) and axial (B) T2-weighted magnetic resonance imaging reveal high signal intensity (arrow) within the spinal cord on cranio-cervial junction and compressed thecal sac on left side (arrow head).
Fig. 3
Fig. 3
Postoperative sagittal (A), axial (B) computed tomography reveal thecal sac decompression by partial removal of left posterior arch of C1, 2.
See this image and copyright information in PMC

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