Open AccessSymptomatic Atlas Hypoplasia in a Latin-American Patient: Case Report and Literature Review
Author(s) -
Matías Pereira Duarte,
Gastón Camino-Willhuber,
Matías Petracchi,
Marcelo Gruenberg,
Carlos Solá
Publication year - 2021
Publication title -
journal of the american academy of orthopaedic surgeons. global research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.358
H-Index - 2
ISSN - 2474-7661
DOI - 10.5435/jaaosglobal-d-21-00041
Subject(s) - medicine , myelopathy , hypoplasia , atlas (anatomy) , laminectomy , asymptomatic , surgery , population , spinal cord , anatomy , environmental health , psychiatry
Background: Atlas hypoplasia is an infrequent cause of upper cervical stenosis. Only 24 cases in nonsyndromic adult population have been published. We are not aware of previous reports describing isolated fully formed atlas hypoplasia in a Latin-American patient. The purpose of this work was to report a case of an 80-year-old Argentinian woman with cervical myelopathy because of atlas hypoplasia and a literature review about this subject. Methods: A clinical case and an extended review of the literature are presented. We assessed from each case: age, sex, posterior atlanto-dens interval, surgical treatment, outcomes, and follow-up period. Results: Neurologic symptoms markedly improved after posterior decompression from severe to moderate in the Japanese Orthopaedic Association Scoring System and from four to three on the Nurick scale. Twenty-five patients were analyzed (mean 58.4 years, 32% female). The mean posterior atlanto-dens interval was 8.8 mm. Twenty-three patients underwent decompression alone, and two needed posterior fusion. All patients reported clinical improvement at an average follow-up of 13 months. Conclusion: Cervical myelopathy caused by fully formed atlas hypoplasia is not an exclusive pathology of far east population, and it may present in nonsyndromic patients. Surgical treatment by C1 laminectomy improved neurologic impairment. Study Design: Case report and literature review.