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Unilateral Accessory Articular Facet at C1 to C2
Francisco de Assis Ulisses Sampaio Júnior1, Oscar L Alves2, Francisco Ricardo Borges Ribeiro1
1Spine Department, Sirio-Libanês Hospital, São Paulo, Brazil.
International Journal of Spine Surgery
|April 30, 2026
Summary
An uncommon accessory C1-C2 facet joint caused cervical spinal cord compression and motor deficits. Surgical removal of the facet joint relieved the patient's symptoms, highlighting rare anatomical causes of spinal issues.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Anatomy
Background:
- Accessory C1-C2 articular facets are rare anatomical variations.
- Cervical spinal cord compression can result from various pathologies, including atypical bony structures.
Purpose of the Study:
- To report a case of cervical spinal cord compression caused by a unilateral accessory C1-C2 facet.
- To describe the surgical management and outcome for this rare condition.
Main Methods:
- Case report of a 41-year-old male with neck pain and motor impairment.
- Diagnostic imaging (cervical MRI/CT) to identify the accessory facet and spinal cord compression.
- Surgical decompression via C2 laminectomy and arthrectomy of the accessory facet.
Main Results:
- The patient presented with neck pain and progressive fine motor skill impairment.
- Cervical imaging confirmed a right-sided accessory C1-C2 facet causing significant spinal cord compression.
- Post-operative follow-up showed complete resolution of motor deficits.
Conclusions:
- Atypical anatomical variations, such as accessory C1-C2 facets, should be considered in the differential diagnosis of cervical spinal symptoms.
- Surgical decompression is an effective treatment for spinal cord compression caused by accessory facet joints.
- This case adds to the limited literature on accessory C1-C2 facet pathology.
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