We report a unique case of compressive myelopathy caused by late kyphosis angulation of a previously operated dens base fracture nonunion challenged by age-related ankyloses of the lateral articulations C1 to C2 and a solid posterior fusion mass.
Posterior column shortening such as commonly practiced for progressive kyphosis or myelopathy may be precluded at the atlantoaxial level for potential vascular risk to the vertebral artery. A standard anterior cervical approach and the application of basic surgical spine care principles lead to a simple solution in the unique and highly complex anatomy of our case.
1Orthopedic Surgery/Spine, McMaster University, Hamilton, Ontario, Canada
E-mail address for D.A. Bednar: email@example.com
Investigation performed at McMaster University, Hamilton, Ontario, Canada
Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSCC/A787).