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Bipartite Atlas With Os Odontoideum and Synovial Cyst: Case Report and Review Literature

Weng, Chong, MD; Wang, Li-Min, MD; Wang, Wei-Dong, MD; Tan, Hong-Yu, MD

doi: 10.1097/BRS.0b013e3181cda10c
Case Reports
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Study Design. Case report and review of the literature.

Objective. To present an os odontoideum with bipartite atlas and synovial cyst at the C1–C2 junction in a 13-year-old girl and to review the relevant background literature.

Summary of Background Data. Bipartite atlas associated with os odontoideum and synovial cyst at the C1–C2 junction is extremely rare.

Methods. The patient's clinical presentation, evolution of physical findings, and sequential radiologic studies. Surgery of the bipartite atlas with os odontoideum and synovial cyst. Posterior fixation between occipital and C 2 without resection of the mass was performed.

Results. The patient had significant improvement and spontaneous regression of the cyst was identified on the follow-up magnetic resonance imaging (MRI) taken 3 months after posterior fixation. To our knowledge, no case of a bipartite atlas with os odontoideum and synovial cyst with complete recovery of an accompanying quadriparesis after reduction has been previously reported in English medical literature.

Conclusion. We described a rare association of an anterior arch defect, posterior arch aplasia, os odontoideum, and synovial cyst at the C1–C2 junction. This case report supports surgical intervention of synovial cyst with craniovertebral instability using posterior fixation without resection of the cyst.

We reported a rare association of an anterior arch defect, posterior arch aplasia, os odontoideum, and synovial cyst at the C1–C2 junction in a 13-year-old girl who complete recovery of an accompanying quadriplegia after posterior reduction without resection of the cyst.

From the Department of Orthopedic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.

Acknowledgment date: October 19, 2009. Revision date: October 27, 2009. Acceptance date: November 16, 2009.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Address correspondence and reprint requests to Li-Min Wang, MD, Department of Orthopedic Surgery, NO. 1, Jianshe East Raod, Zhengzhou, Henan 450052, China; E-mail: gu2ke@yahoo.com.cn

© 2010 Lippincott Williams & Wilkins, Inc.