Management of basilar invagination and atlanto-axial subluxation via distraction of C1-C2 joint using intraarticular spacers and occipito-C2 fixation
by Cumhur Kilincer
History and examination
This 23-year-old female was admitted with complaints of diffuse neck pain, numbness in the arms, and occasional unsteady gait and dizziness for 2 years. There was no history of trauma or any other disease. The physical examination was normal. The neurologic examination revealed normal findings other than slightly increased deep tendon reflexes.
Cervical spine X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) revealed a grossly anomalous cranio-cervical junction anatomy. The findings included: an occipitalized atlas, basilar invagination, atlanto-axial subluxation, Chiari type 1 malformation and cervical syringomyelia (Figures 1-4).