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Case Reports
. 2017 Jun 9;9(6):e1327.
doi: 10.7759/cureus.1327.

Complete Atlantooccipital Assimilation with Basilar Invagination and Atlantoaxial Subluxation Treated Non-Surgically: A Case Report

Ali J Electricwala  1 , Amita Harsule  2 , Vishwajeet Chavan  3 , Jaffer T Electricwala  1
Affiliations
Case Reports

Complete Atlantooccipital Assimilation with Basilar Invagination and Atlantoaxial Subluxation Treated Non-Surgically: A Case Report

Ali J Electricwala et al. Cureus. .

Abstract

Atlantooccipital assimilation is a partial or complete congenital fusion between the atlas and the base of the occiput. Most patients with atlas assimilation are asymptomatic, but some may present with neurological problems such as myelopathy. We present the case of a 37-year-old woman who presented with neck and occipital pain, episodic neck stiffness, and dizziness. Medical imaging revealed complete atlantooccipital assimilation associated with basilar invagination, atlantoaxial subluxation, and predisposing anterior spinal cord compression. The patient was treated non-operatively with medications, cervical interferential therapy, and a rigid cervical orthosis.

Keywords: atlantoaxial subluxation; basilar invagination; complete atlantooccipital assimilation; predisposing anterior cord compression; treated non-surgically.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Lateral radiograph of the cervical spine falsely interpreted as "congenital absence of atlas" (arrow)
Figure 2
Figure 2. Coronal short tau inversion recovery (STIR) magnetic resonance imaging scan showing complete atlantooccipital assimilation (arrow)
Figure 3
Figure 3. 3D computed tomography scan showing complete atlantooccipital assimilation (arrow)
Figure 4
Figure 4. Coronal computed tomogram scan showing complete atlantooccipital assimilation (arrow)
Figure 5
Figure 5. Sagittal computed tomogram showing increased atlanto-dens interval (7 mm) suggestive of atlanto-axial instability (arrow)
Figure 6
Figure 6. Sagittal computed tomogram showing basilar invagination (tip of the odontoid is located above the Chamberlain line)
Figure 7
Figure 7. Sagittal computed tomogram showing reduced cranio-vertebral angle
Figure 8
Figure 8. Sagittal T2-weighted magnetic resonance imaging showing compressive myelopathy
Figure 9
Figure 9. Axial T2-weighted magnetic resonance imaging showing compressive myelopathy
See this image and copyright information in PMC

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