Symptomatic C1-2 fusion failure due to a fracture of the lateral C-1 posterior arch in a patient with rheumatoid arthritis. Case report and review of the literature.

The authors report a case in which the lateral C-1 arch fractured in a patient with rheumatoid arthritis and an intact fusion mass; this patient had previously undergone a C1-2 Brooks-type fusion. This unique complication occurred secondary to continued resorption of the C1-2 rheumatoid pannus. Two years after occipitocervical fusion the patient has made a complete neurological recovery.