Zhu Y, Wu XX, Jiang AQ, Li XF, Yang HL, Jiang WM. Single door laminoplasty plus posterior fusion for posterior atlantoaxial dislocation with congenital malformation: A case report and review of literature. World J Clin Cases 2020; 8(23): 6136-6143 [PMID: 33344615 DOI: 10.12998/wjcc.v8.i23.6136]
Corresponding Author of This Article
Wei-Min Jiang, MD, PhD, Doctor, Full Professor, Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, No. 899 Pinghai Street, Suzhou 215000, Jiangsu Province, China. jwm858188@sina.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Dec 6, 2020; 8(23): 6136-6143 Published online Dec 6, 2020. doi: 10.12998/wjcc.v8.i23.6136
Single door laminoplasty plus posterior fusion for posterior atlantoaxial dislocation with congenital malformation: A case report and review of literature
Yi Zhu, Xie-Xing Wu, An-Qing Jiang, Xue-Feng Li, Hui-Lin Yang, Wei-Min Jiang, Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
Author contributions: Jiang WM was the surgeon for this patient and conceived and designed the study; Zhu Y, Wu XX and Jiang AQ reviewed the literature; Zhu Y and Jiang AQ contributed to manuscript drafting; Zhu Y, Wu XX and Li XF contributed to data acquisition and analysis; Yang HL, Jiang WM and Li XF were responsible for critical revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei-Min Jiang, MD, PhD, Doctor, Full Professor, Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, No. 899 Pinghai Street, Suzhou 215000, Jiangsu Province, China. jwm858188@sina.com
Received: June 27, 2020 Peer-review started: June 27, 2020 First decision: September 23, 2020 Revised: October 5, 2020 Accepted: October 19, 2020 Article in press: October 19, 2020 Published online: December 6, 2020 Processing time: 160 Days and 8.2 Hours
Abstract
BACKGROUND
Posterior atlantoaxial dislocation (PAD) is a rare type of upper cervical spine disease. We sought to describe a unreported case of old PAD with os odontoideum (OO) and atlas hypoplasia (AH) and our unique treatment approach consisting of C1 single door laminoplasty with C1-3 posterior fixation and fusion.
CASE SUMMARY
A 70-year-old male patient who suffered from progressive aggravating numbness and limb weakness for 4 years without trauma, was diagnosed with old PAD with OO and AH. The patient underwent closed reduction and C1 single door laminoplasty with C1-3 posterior fixation and fusion instead of C1 laminectomy with occipitocervical fusion. During the 3-year follow-up, he was able to walk by himself instead of using a wheelchair and with a ± 25° range of head rotation as well as a ± 10° range of flexion-extension. Three-year follow-up images showed satisfactory reduction and fusion.
CONCLUSION
C1 single door laminoplasty with cervical fusion in PAD combined with spinal cord compression could be a suitable and effective surgical option. Compared with laminectomy and occipitocervical fusion, it retains more cervical range of motion, has a smaller incision and provides an adequate bone grafting space for atlantoaxial fusion.
Core Tip: This article describes an unreported case of old posterior atlantoaxial dislocation with os odontoideum and atlas hypoplasia. C1 single door laminoplasty with C1-3 posterior fixation and fusion was performed as surgical treatment, which retained partial range of motion, decreased operative trauma and provided an adequate bone grafting space for atlantoaxial fusion compared with laminectomy and occipitocervical fusion.
