Ponticulus posticus is an abnormal bony bridge of posterior arch of atlas. The resulting foramen contains the vertebral artery and has clinical significance in lateral mass screw insertion into the first cervical vertebra. The authors report an atlantoaxial subluxation case showing a ponticulus posticus, which was surgically treated with posterior atlantoaxial screw fixation under the guidance of O-arm(R) imaging system coupled with navigation.
Atlanto-Axial Joint ; Congenital Abnormalities ; Humans ; Spine ; Vertebral Artery

Fibrous dysplasia is a benign disorder of bone primarily affecting young people from childhood through the third decade. It usually manifests as an enlargement of bones in and about the orbits or the the cranial vault. Whether localized or diffuse, it rarely involves the cervical spine. We report a case of fibrous dysplasia involving axis combined with atlantoaxial instability which was caused by odontoid process fracture. Transfacetal screw fixation augmented with Halifax interlaminar clamp technique was applied to obtain atlantoaxial stability. Postoperative course was unevenful and postoperative radiologic findings revealed favorable fixation of atlantoaxial joint. The pertinent literature on fibrous dysplasia and atlantoaxial instability is reviewed and discussed.
Atlanto-Axial Joint ; Axis, Cervical Vertebra ; Odontoid Process ; Orbit ; Spine*

We describe the use of a C1 laminar screw in combination with a C2 laminar screw as a salvage technique to treat two patients, one with persistent first intersegmental artery and the other with vertebral artery occlusion after cervical spine fracture. The combined use of C1 and C2 laminar screws allows for good fixation of the atlantoaxial joint with a lower risk of vertebral artery injury; therefore, it can be an alternative surgical procedure for patients with congenital or traumatic anomalous vertebral artery.
Arteries ; Atlanto-Axial Joint ; Humans ; Spine ; Vertebral Artery

Occipito-atlantalrotatory subluxation that occurs in conjunction with atlanto-axial rotator fixation is extremely rare. The common clinical characteristics are painful torticollis and cock robin position presented with the head tilted to one side and rotated to the other side. The object of this report is to emphasize that AARF combined with OARF may be caused by a variety of conditions, to be must need algorithm for proper management, apparently. A torticollis patient who had cerebral palsy presented with severe nuchal pain and wryneck for a long period. The patient had a history of fallen down 16 years ago which caused severe nuchal pain. The conservative management had failed to correct the deformity and instability. we decided to operate using occiput-C1-C2 arthrodesis and C3-4-5 bilateral screw fixation for reinforcement. Now he doesn't have neurologic deficit and shows good outcome enough to sustain his head, not using his hands, in his daily life.
Arthrodesis ; Atlanto-Axial Joint ; Atlanto-Occipital Joint ; Cerebral Palsy* ; Congenital Abnormalities ; Hand ; Head ; Humans ; Neurologic Manifestations ; Songbirds ; Torticollis

Grisel syndrome is a rare, non-traumatic atlanto-axial subluxation associated with an inflammatory or infectious process in the upper neck. According to the two-hit hypothesis, which is widely accepted for the pathogenesis of Grisel syndrome, preexisting ligamentous laxity of the atlanto-axial joint is regarded as the first hit. An inflammatory or infectious process of the atlanto-axial joint acts as the second hit, resulting in non-traumatic atlanto-axial subluxation. We report on a 6-year-old girl with atlanto-axial subluxation following retropharyngeal and cervical lymphadenitis. She was diagnosed with Grisel syndrome, for which an initial computed tomography did not show any preexisting ligamentous laxity of the atlanto-axial joint. A literature review found only 4 case reports on Grisel syndrome with an initially normal atlanto-axial joint. The present case offers some evidence that a single hit, such as inflammatory changes in the atlanto-axial joint, might cause Grisel syndrome, even without underlying ligamentous laxity.
Atlanto-Axial Joint* ; Child ; Female ; Humans ; Joint Instability ; Ligaments ; Lymphadenitis ; Neck ; Torticollis

Atlanto-Axial Joint ; injuries ; Child ; Humans ; Joint Dislocations ; etiology ; Male ; Tympanoplasty ; adverse effects

Atlanto-Axial Joint ; injuries ; surgery ; Decompression, Surgical ; Fracture Fixation, Internal ; methods ; Humans ; Joint Dislocations ; surgery ; Traction

Atlanto-Axial Joint ; physiopathology ; Humans ; Joint Diseases ; physiopathology ; therapy ; Musculoskeletal Manipulations

Adenoidectomy ; statistics & numerical data ; Atlanto-Axial Joint ; Child ; Humans ; Joint Dislocations ; etiology ; Postoperative Complications

joint disk-like structure at the anterior component of the median atlanto-axial joint. At mid-term, the disk-like structure was thick (0.1–0.15 mm) relative to the sizes of bones surrounding the joint. However, it did not completely separate the joint cavity, and was absent in the inferior and/or central part of the cavity. This morphology was similar to the so-called fibroadipose meniscoid of the lumbar zygapophysial joint that is usually seen in adults. In mid-term fetuses, there was evidence suggesting that a mesenchymal tissue plate was separated from a roof of the joint cavity. In late-stage fetuses, the thickness (less than 0.15 mm) was usually the same as, or less than that at mid-term, and the disk-like structure was often flexed, folded and fragmented. Therefore, in contrast to the zygapophysial meniscoid as a result of aging, the present disk-like structure was most likely a temporary product during the cavitation process. It seemed to be degenerated in late-stage fetuses and possibly also in newborns. Anomalies at the craniocervical junction such as Chiari malformations might accompany this disk-like structure at the median atlanto-axial joint even in childhood.]]>
Adult ; Aging ; Atlanto-Axial Joint ; Fetus ; Humans ; Infant, Newborn ; Joints ; Zygapophyseal Joint