K Tofuku1, H Koga, K Yone, S Komiya. 1. Department of Orthopaedic Surgery, Kagoshima Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Abstract
STUDY DESIGN: A case report of myelopathic hypoplasia of the atlas with situs inversus totalis. OBJECTIVES: To describe a case of cervical myelopathy caused by hypoplasia of the atlas with situs inversus totalis, and to briefly review the pertinent literature. SETTING: Department of Orthopaedic Surgery, Kagoshima, Japan. METHODS: The history, results of examination, and findings of radiographic imaging studies for a 56-year-old man with a 10-year history of progressive myelopathy who presented to our hospital are described. RESULTS: Imaging studies revealed congenital hypoplasia of the atlas, ossification of the posterior longitudinal ligament at the levels of C3-C4, and situs inversus totalis. He underwent laminectomy of the atlas and laminoplasty of C3-C7 for decompression of the spinal cord. Operative intervention resulted in significant neurological improvement and relief of occipital neuralgia. CONCLUSION: To our knowledge, no case of myelopathic hypoplasia of the atlas with situs inversus totalis has previously been described. When encountering inherited disorders such as situs inversus totalis, a thorough search must be made for anomalies of the craniovertebral junction.
STUDY DESIGN: A case report of myelopathic hypoplasia of the atlas with situs inversus totalis. OBJECTIVES: To describe a case of cervical myelopathy caused by hypoplasia of the atlas with situs inversus totalis, and to briefly review the pertinent literature. SETTING: Department of Orthopaedic Surgery, Kagoshima, Japan. METHODS: The history, results of examination, and findings of radiographic imaging studies for a 56-year-old man with a 10-year history of progressive myelopathy who presented to our hospital are described. RESULTS: Imaging studies revealed congenital hypoplasia of the atlas, ossification of the posterior longitudinal ligament at the levels of C3-C4, and situs inversus totalis. He underwent laminectomy of the atlas and laminoplasty of C3-C7 for decompression of the spinal cord. Operative intervention resulted in significant neurological improvement and relief of occipital neuralgia. CONCLUSION: To our knowledge, no case of myelopathic hypoplasia of the atlas with situs inversus totalis has previously been described. When encountering inherited disorders such as situs inversus totalis, a thorough search must be made for anomalies of the craniovertebral junction.