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Atlantoaxial instability complicating radiation therapy for recurrent nasopharyngeal carcinoma. A case report
1Toronto Hospital Spine Program, Department of Surgery, University of Toronto, Canada.
Study Design:
A case report of a patient in whom atlantoaxial instability developed secondary to repeat radiation therapy for recurrent nasopharyngeal carcinoma.
Objectives:
To illustrate a dramatic and previously unreported complication of local radiation to the posterior nasopharynx.
Summary Of Background Data:
Nasopharyngeal carcinoma is an unusual tumor that usually is managed with local, external-beam radiation. It is not thought to involve the cervical spine directly, although local invasion of the skull base is common.
Methods:
A review of the medical records and radiographs of the only patient known to develop this complication of radiation used to manage nasopharyngeal carcinoma.
Results:
Atlantoaxial instability developed in a patient as a result of repeat radiation for a locally recurrent tumor. The instability was associated with intrusion of the anterior arch of C1 into the posterior nasopharynx and was managed successfully with a posterior stabilization using transarticular screws and supplemental wiring.
Conclusions:
Patients who have undergone local irradiation for nasopharyngeal carcinoma may be at risk for developing atlantoaxial instability.