[Spastic tetraparesis secondary to untreated os odontoideum]

This case report describes a 63-year-old woman, who had an undiscovered os odontoideum for three years and underwent therapy by a chiropractor and a physiotherapist, before the diagnosis was made. Os odontoideum is unknown to most doctors, and increased knowledge of the disease is of great importance, since inappropriate treatment in the form of manipulation and neck exercises might worsen the disease. In case of prolonged or uncharacteristic neck symptoms, the diagnosis should be considered, and a normal cervical X-ray would provide the diagnosis. If os odontideum is suspected, the patient should be referred to a highly specialised spine centre at a university hospital.