Published online Dec 6, 2020. doi: 10.12998/wjcc.v8.i23.6136
Peer-review started: June 27, 2020
First decision: September 23, 2020
Revised: October 5, 2020
Accepted: October 19, 2020
Article in press: October 19, 2020
Published online: December 6, 2020
Processing time: 160 Days and 8.2 Hours
Posterior atlantoaxial dislocation (PAD) is a rare type of upper cervical spine disease. We sought to describe a unreported case of old PAD with os odontoideum (OO) and atlas hypoplasia (AH) and our unique treatment approach consisting of C1 single door laminoplasty with C1-3 posterior fixation and fusion.
A 70-year-old male patient who suffered from progressive aggravating numbness and limb weakness for 4 years without trauma, was diagnosed with old PAD with OO and AH. The patient underwent closed reduction and C1 single door laminoplasty with C1-3 posterior fixation and fusion instead of C1 laminectomy with occipitocervical fusion. During the 3-year follow-up, he was able to walk by himself instead of using a wheelchair and with a ± 25° range of head rotation as well as a ± 10° range of flexion-extension. Three-year follow-up images showed satisfactory reduction and fusion.
C1 single door laminoplasty with cervical fusion in PAD combined with spinal cord compression could be a suitable and effective surgical option. Compared with laminectomy and occipitocervical fusion, it retains more cervical range of motion, has a smaller incision and provides an adequate bone grafting space for atlantoaxial fusion.
Core Tip: This article describes an unreported case of old posterior atlantoaxial dislocation with os odontoideum and atlas hypoplasia. C1 single door laminoplasty with C1-3 posterior fixation and fusion was performed as surgical treatment, which retained partial range of motion, decreased operative trauma and provided an adequate bone grafting space for atlantoaxial fusion compared with laminectomy and occipitocervical fusion.