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Dynamic CT scan of the craniovertebral junction: a role in the management of os odontoideum
Affiliations- department of neurosurgery
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Abstract
Os odontoideum is an uncommon abnormality of the craniovertebral junction (CVJ) that exists as a separate ossicle apart from a hypoplastic dens. Its genesis and natural history have been debated, and its proper treatment remains uncertain. A 48-year-old woman complained of persistent upper neck pain and paraesthesia of her left side. Magnetic resonance imaging of the CVJ demonstrated an os odontoideum. Dynamic computed tomography scan of the CVJ showed a reduction of the space available for the spinal cord to 50% from extended to flexed position. The patient underwent posterior spinal fusion of C1–C2 using a sublaminar titanium hook and rods fixed in moderate extension.
We discuss the usefulness of the dynamic computed tomography (CT) scan in the evaluation of atlantoaxial motion and the management of this pathology.
Abstract
Os odontoideum is an uncommon abnormality of the craniovertebral junction (CVJ) that exists as a separate ossicle apart from a hypoplastic dens. Its genesis and natural history have been debated, and its proper treatment remains uncertain. A 48-year-old woman complained of persistent upper neck pain and paraesthesia of her left side. Magnetic resonance imaging of the CVJ demonstrated an os odontoideum. Dynamic computed tomography scan of the CVJ showed a reduction of the space available for the spinal cord to 50% from extended to flexed position. The patient underwent posterior spinal fusion of C1–C2 using a sublaminar titanium hook and rods fixed in moderate extension.
We discuss the usefulness of the dynamic computed tomography (CT) scan in the evaluation of atlantoaxial motion and the management of this pathology.
Keywords
os odontoideum, dynamic CT scan, craniovertebral junction, posterior approach, space available for the spinal cord
About this articleTitle
Dynamic CT scan of the craniovertebral junction: a role in the management of os odontoideum
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
603-608
Page views
346
Article views/downloads
1063
DOI
10.1016/S0028-3843(14)60159-6
Bibliographic record
Neurol Neurochir Pol 2010;44(6):603-608.
Keywords
os odontoideum
dynamic CT scan
craniovertebral junction
posterior approach
space available for the spinal cord
Authors
Abad Cherif El Asri
Ali Akhaddar
Miloudi Gazzaz
Naama Okacha
Omar Boulhroud
Hassan Baallal
Hatim Belfquih
Adil Belhachmi
Cherkaoui Mandour
Brahim El Mostarchid
Mohamed Boucetta
