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Hypoplasia of C1's posterior arch: Is there an ideal anatomical classification?
Messias Gonçalves Pacheco Junior1, Nicoly Augusta da Silva Quezada Dos Santos1, Raphael Tavares Ribeiro1
1Department of Neurosurgery, Antônio Pedro University Hospital, Federal Fluminense University, Niteroi, Rio de Janeiro, Brazil.
Background:
Congenital anomalies of the atlas are rare and usually occur in conjunction with other congenital variants. They include a wide spectrum of anomalies ranging from clefts to hypoplasia or aplasia of its arches that may contribute to spinal cord compressive syndrome.
Case Description:
A 54-year-old male presented with the sudden onset of a severe quadriparesis and loss of proprioception after a minor fall. The magnetic resonance (MR) scan showed cord compression at the C1 level attributed to C1 arch hypoplasia. Two months following a decompressive C1 laminectomy without fusion, and the patient was symptom free.
Conclusion:
Posterior C1 arch hypoplasia is a rare anomaly that can contribute to cervical cord compression and myelopathy. The optimal surgical management may include, as in this case, a posterior decompression without fusion.
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