Spontaneous Anterior Atlas Fracture Following C1 Laminectomy without Fusion: A Case Report

Abstract

C1 laminectomy without fusion (CLWF) is a widely accepted minimally invasive surgical technique to decompress the spinal cord around the craniovertebral junction. In the case presented herein, a 46-year-old man experienced a fracture of the anterior arch of the atlas that occurred during the postoperative period following CLWF to treat cervical myelopathy associated with a retro-odontoid pseudotumor. The findings demonstrate that disruption of the integrity of the posterior arch of the atlas confers an increased risk of anterior arch fracture. Although CLWF is a good surgical option for treating stable cervical myelopathy associated with a retro-odontoid pseudotumor, posterior decompression and fusion could be beneficial for patients with a relatively high inferior facet angle of C1-2 and subaxial arthrodesis.