PubMed · 13921105
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R THUREL, J NEHLIL, P O'KEEFE. [Traumatic axoatloid dislocation].. https://pubmed.ncbi.nlm.nih.gov/13921105/
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STUDY DESIGN: A case report and review of previous literature are presented. OBJECTIVE: The objective of this manuscript was to report a case of cervical myelopathy due to anomalous laminae of the axis in a patient with spina bifida. SUMMARY OF BACKGROUND DATA: In previous studies, few cases of invaginated anomalous laminae of the axis have been reported. Treatment was surgical removal of the invaginated laminae. METHODS: The patient's history, clinical examination, imaging findings, and treatment were reported. RESULTS: Characteristic findings were revealed from imaging studies, a multiplane reconstruction of the CT images, and a stereolithographic model of the cervical spine. The patient was treated with a posterior decompressive operation. The outcome was satisfactory, with an improvement in the patient's neurology. CONCLUSIONS: This is a report of a rare characteristic anomaly of the laminae of the axis. A multiplane reconstruction of the CT images and a stereolithographic model were useful for treatment of this case. Possible causes of this anomaly may be the failure of ossification or fusion of the embryological term.
BACKGROUND: Chronic low back pain (LBP), the leading symptom of ankylosing spondylitis (AS) and undifferentiated axial spondyloarthritis (SpA), precedes the development of radiographic sacroiliitis, sometimes by many years. OBJECTIVE: To assign disease probabilities and to develop an algorithm to help in the early diagnosis of axial SpA. METHODS: Axial SpA comprises AS and undifferentiated SpA with predominant axial involvement. Clinical features include inflammatory back pain (IBP), alternating buttock pain, enthesitis, arthritis, dactylitis, acute anterior uveitis, a positive family history, psoriasis, inflammatory bowel disease, and good response to NSAIDs. Associated laboratory findings include raised acute phase reactions, HLA-B27 association, and abnormalities on skeletal imaging. Sensitivities, specificities, and likelihood ratios (LRs) of these parameters were determined from published studies. A 5% prevalence of axial SpA among patients with chronic LBP was used. The probability of the presence of axial SpA, depending on the presence or absence of the above clinical features of SpA, was determined. A probability of > or = 90% was used to make a diagnosis of axial SpA. RESULTS: The presence of inflammatory back pain features increased the probability of axial SpA from the background 5% prevalence to 14%. The presence of 2-3 SpA features was necessary to increase the probability of axial SpA to 90%. The highest LRs were obtained for HLA-B27 and MRI. Diagnostic algorithms to be used in daily practice were suggested. CONCLUSIONS: This approach can help clinicians to diagnose with a high degree of confidence axial SpA at an early stage in patients with IBP who lack radiographic sacroiliitis.
At the craniocervical junction, developmental anomalies of the axis may produce clinical symptoms by compressing the upper cervical cord during movements of the head and neck. The present study aimed at investigating several varieties and deformities of the axis on skeletal specimens of Eastern Anatolian origin. On 76 specimens, developmental anomalies and the variants of the second vertebrae (axis) were investigated. Hypoplasia of the dens axis in one specimen, the dens axis of a child with a bifid apex in another specimen and an arthrotic formation located on the apex of the dens in six axes were found. A bone protrusion narrowing the transverse foramen was also observed. The types of absence of the dens axis and clinical symptoms that may be caused by them are discussed. It was concluded that the frequency of arthrotic formations might reflect the possibility that the individuals suffered less commonly from neck pain due to arthrotic degeneration.