Unilateral atlantal lateral mass hypertrophy. Report of four cases

Journal of Neurosurgery. Spine
Atul GoelRam Menon

Abstract

The authors report the cases of four patients in whom they diagnosed an extremely rare and hitherto unreported clinical condition-unilateral hypertrophy of the C-1 lateral mass causing symptomatic cord compression. All patients presented with long-standing torticollis and progressive myelopathy. Three patients underwent posterior decompressive surgery and one underwent resection of the part of the lateral mass invading into the spinal canal and subsequent atlantoaxial plate and screw fixation. Clinical improvement of varying degrees occurred in all cases following surgery. The clinical recovery, however, was most remarkable in the patient who underwent resection of the bone portion indenting the cord. The follow-up periods ranged from 2 to 14 years. The remarkable similarity in the presenting clinical and radiological/neuroimaging features in all four patients suggests that unilateral hypertrophy of the lateral mass of atlas may be a defined clinical entity. The treatment strategy needs to be evaluated; however, resection of the compression-causing portion of the hypertrophic bone appears to be the best treatment option.

References

Jan 1, 1997·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·M Barry, P Livesley
Aug 3, 1999·Neurology·M RichardsM Wadsworth
Jul 21, 2001·Spinal Cord·U K ChangH J Kim

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Citations

Nov 20, 2012·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·Eijiro OnishiMutsumi Matsushita
Oct 22, 2008·Journal of Neurosurgery. Spine·Atul GoelRam Menon
Mar 2, 2010·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Atul Goel, Abhidha Shah
Jan 31, 2014·Neurologia Medico-chirurgica·Hitoshi YamahataMasakazu Takayasu
Jan 1, 2013·Asian Spine Journal·Manish Kumar Kasliwal, Vincent Charles Traynelis

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