PMC7490141_01
photo showing psoriatic skin lesions
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F1
Clinical examination revealed extensive skin lesions on the trunk and on all four limbs in the form of rounded or polycyclic red patches (Figure 1) and a pyramidal tract syndrome with predominantly left-sided muscle weakness.
dynamic X-rays showing overt C1-C2 instability and C3/C4 retrolisthesis
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F2
Dynamic X-rays showed obvious C1-C2 instability (Figure 2).
MRI appearance in T1 and T2 showing instability and signs of spinal cord pain
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F3
Magnetic resonance imaging (MRI) showed damage to the transverse ligament resulting in C1-C2 dislocation (increased space between the odontoid and posterior arch of C1) and the presence of retrolisthesis of C3 relative to C4 with signs of spinal cord compression at this level (Figure 3).
intraoperative view after laminectomy C3, C4, C5
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F4
The patient had an instrumented posterior arthrodesis C1, C2, C3, C4 and C5 associated with laminectomy C3, C4 and C5 (Figure 4, Figure 5).
X-rays (6 months later)
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F5
The patient had an instrumented posterior arthrodesis C1, C2, C3, C4 and C5 associated with laminectomy C3, C4 and C5 (Figure 4, Figure 5).