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Surgical Management in Cervical Spondylotic Myelopathy Due to Alkaptonuria
Ali Karadag1, Evren Sandal1, Erik H Middlebrooks2
1Department of Neurosurgery, Saglik Bilimleri University, Tepecik Research and Training Hospital, Izmir, Turkey.
Background:
Ochronotic arthropathy related to alkaptonuria is a rare condition. Cervical spine involvement with myelopathic features has been even more rarely described, particularly related to atlantoaxial instability. As such, little is known about the optimal surgical management in these patients.
Case Description:
We described the first case, to our knowledge, of a patient with alkaptonuria and related cervical spondylotic myelopathy from pannus formation at the atlantoaxial joint. We describe our choices in surgical management of this rare condition in a patient with an excellent outcome.
Conclusion:
Ochronotic cervical spondylotic myelopathy is a rare condition and may require additional considerations in surgical treatment compared to more common causes of cervical spondylotic myelopathy. In our case, we elected for decompression with posterior occipitocervical screw fixation and were able to achieve neurologic recovery with no complications, currently at 2-year follow-up.
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