PMC1602181_01
X-rays of the cervical spine in neutral position (a), flexion (b) and extension (c). Ventral subluxation of C1 over C2 in flexion (b), which reduces on extension (c)
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Fig1
Additionally midline clefts of the anterior and posterior arch of the atlas became evident (Figs. 1, 2).
CT scans reveal midline clefts of the anterior and posterior arch of the atlas (a). Displaced os odontoideum and subluxation of C1 over C2 with narrowing of the spinal canal (b)
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Fig2
Additionally midline clefts of the anterior and posterior arch of the atlas became evident (Figs. 1, 2).
T2-weighted MRI images with increased cord signals at C1/C2 levels and a persistent subdental synchondrosis
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Fig3
T2-weighted images and a persistent subdental synchondrosis was visualized on T2-weighted turbo spin echo sequences (Fig. 3). The patient underwent closed reduction and posterior atlantoaxial fusion by sublaminar tension band wiring with autologous bone grafting and transarticular lag screw fixation.
Follow-up X-rays 12 months after trauma. Stable atlantoaxial fusion after sublaminar wiring and transarticular screw fixation in ap (a) and lateral (b) view
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Fig4
Radiographs taken 1 year after the trauma showed a stable fusion of C1/C2 (Fig. 4).