Cervical angina caused by atlantoaxial instability

Journal of Spinal Disorders & Techniques
Yoshiyuki ItoMitsuo Ochi

Abstract

Cervical angina is defined as a paroxysmal precordialgia that resembles true cardiac angina caused by cervical spondylosis. Cervical angina most commonly results from compression of the C7 ventral root. We present here a case of cervical angina caused by atlantoaxial instability. This case had marked atlantoaxial instability but no flexibility of the middle to lower levels of the cervical spine. Although there was mild C7 root compression on the radiologic findings, the chest pain was induced by neck motion, and the precordialgia disappeared after posterior atlantoaxial fusion without C7 root decompression. Therefore, we diagnosed this case as cervical angina caused by spinal cord compression at the C1-C2 level. It was speculated that a perturbation of the sympathetic nervous system or a hypofunction of the pain suppression pathway in the posterior horn of the spinal cord caused the pectoralgia. Although cervical angina is a rare disease, physicians should be aware of it; if there are no abnormal findings on cardiac examinations for angina pectoris, they should examine the cervical spine. Cervical angina due to atlantoaxial instability is one of the differential diagnoses of precordialgia.

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Citations

May 9, 2013·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Yu-Qing SunWei Tian
Dec 4, 2012·Journal of the Neurological Sciences·Yoshiharu NakaeYoshiyuki Kuroiwa
Nov 4, 2010·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Nicoline J van LeersumRobert J M Klautz
Feb 14, 2012·The Spine Journal : Official Journal of the North American Spine Society·Hideki Sudo, Reo Goto
Jan 2, 2015·The Neurohospitalist·Walter I SussmanJayant Phadke
Oct 29, 2020·Asian Spine Journal·Fan FengHongxing Shen
Apr 9, 2021·Clinical Spine Surgery : a Spine Publication·Jui-Teng ChienRu-Ping Lee

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