Journal of Neurosciences in Rural Practice
 


 
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IMAGES IN NEUROSCIENCES
Year : 2019  |  Volume : 10  |  Issue : 1  |  Page : 125  

Os Odontoideum


Department of Neurosurgery, Hospital of Sion, CHVR, Sion, Switzerland

Date of Web Publication4-Jan-2019

Correspondence Address:
Arthur Robert Kurzbuch
Hôpital du Valais – Centre Hospitalier du Valais Romand (CHVR), Hôpital de Sion, Service de Neurochirurgie, Avenue du Grand-Champsec 80, CH-1951 Sion
Switzerland
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jnrp.jnrp_252_18

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How to cite this article:
Kurzbuch AR, Fournier JY. Os Odontoideum. J Neurosci Rural Pract 2019;10:125

How to cite this URL:
Kurzbuch AR, Fournier JY. Os Odontoideum. J Neurosci Rural Pract [serial online] 2019 [cited 2019 May 26];10:125. Available from: http://www.ruralneuropractice.com/text.asp?2019/10/1/125/249362



A 73-year-old patient presented to the neurosurgery clinic with a 2-year history of progressive paresthesia and deterioration of the dexterity of his right hand.

Neurologic examination revealed an impairment of fine motor skills of both hands and spastic hypertonus of the lower extremities. Computed tomography of the cervical spine showed a smooth-margined, independent osseous segment separated from the hypoplastic odontoid peg consistent with os odontoideum [[Figure 1]a, arrow].
Figure 1: (a) Sagittal computed tomography of the cervical spine shows a separate odontoid process (arrow) from the body of C2. (b) Sagittal T2-weighted cervical magnetic resonance imaging reveals narrowing and hyperintensity (arrow) of the spinal cord at C2 level

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The etiology of os odontoideum remains controversial with traumatic or congenital hypothesis.[1],[2] It is incidentally discovered or seen in symptomatic patients with cervical myelopathy because of C1–C2 instability and spinal cord compression.[1],[2] In this patient, magnetic resonance imaging revealed narrowing and hyperintensity of the spinal cord at C2 level on the T2-weighted sequence [[Figure 1]b, arrow]. C1–C2 posterior screw-rod stabilization was performed. Within 2 months after surgery, paresthesia had resolved, and the patient was able to write again.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that name and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Arvin B, Fournier-Gosselin MP, Fehlings MG. Os odontoideum: Etiology and surgical management. Neurosurgery 2010;66:22-31.  Back to cited text no. 1
    
2.
Klimo P Jr., Coon V, Brockmeyer D. Incidental os odontoideum: Current management strategies. Neurosurg Focus 2011;31:E10.  Back to cited text no. 2
    


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