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Surgical Treatment for Atlanto-Occipital Subluxation due to Destructive Spondyloarthropathy in a Patient Undergoing Long-Term Hemodialysis.

Wada K, Murata Y, Kato Y - Asian Spine J (2015)

Bottom Line: DSA was also observed in the lower cervical spine.Magnetic resonance imaging showed spinal canal stenosis at both the upper and lower cervical levels.We performed Oc-C7 fixation, C1 laminectomy, and C3-C7 laminoplasty.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Tokyo Women's Medical University, Tokyo, Japan.

ABSTRACT
Destructive spondyloarthropathy (DSA) has been reported in patients undergoing long-term hemodialysis. Cervical spinal lesions, including those of the upper cervical spine, are reported to be some of the most common. To our knowledge, we report for the first time, a case of atlanto-occipital subluxation requiring surgical treatment due to severe myelopathy and nuchal pain in a patient undergoing long-term hemodialysis. The patient was a 66-year-old woman who had undergone hemodialysis for 40 years. She visited our hospital due to an acute progression of gait disturbance and severe nuchal pain. Computed tomography showed posterior subluxation of the atlanto-occipital joints. DSA was also observed in the lower cervical spine. Magnetic resonance imaging showed spinal canal stenosis at both the upper and lower cervical levels. We performed Oc-C7 fixation, C1 laminectomy, and C3-C7 laminoplasty. We first recognized that the atlanto-occipital subluxation was caused by the extremely long-term, in this case, 40 years, hemodialysis.

No MeSH data available.


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Magnetic resonance imaging shows spinal canal stenosis at the upper cervical level and C3-C7.
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Figure 2: Magnetic resonance imaging shows spinal canal stenosis at the upper cervical level and C3-C7.

Mentions: Sagittal computed tomography (CT) at the atlanto-occipital joints levels showed bone cysts and posterior subluxation of the bilateral joints (Fig. 1A, B). Sagittal CT at the midline level showed the clivus located posterior to the odontoid process, suggesting posterior subluxation of the atlanto-occipital joints. DSA changes were also observed in the lower cervical spine (Fig. 1C). Magnetic resonance imaging (MRI) showed spinal canal stenosis at both the upper and lower cervical levels (Fig. 2).


Surgical Treatment for Atlanto-Occipital Subluxation due to Destructive Spondyloarthropathy in a Patient Undergoing Long-Term Hemodialysis.

Wada K, Murata Y, Kato Y - Asian Spine J (2015)

Magnetic resonance imaging shows spinal canal stenosis at the upper cervical level and C3-C7.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4522456&req=5

Figure 2: Magnetic resonance imaging shows spinal canal stenosis at the upper cervical level and C3-C7.
Mentions: Sagittal computed tomography (CT) at the atlanto-occipital joints levels showed bone cysts and posterior subluxation of the bilateral joints (Fig. 1A, B). Sagittal CT at the midline level showed the clivus located posterior to the odontoid process, suggesting posterior subluxation of the atlanto-occipital joints. DSA changes were also observed in the lower cervical spine (Fig. 1C). Magnetic resonance imaging (MRI) showed spinal canal stenosis at both the upper and lower cervical levels (Fig. 2).

Bottom Line: DSA was also observed in the lower cervical spine.Magnetic resonance imaging showed spinal canal stenosis at both the upper and lower cervical levels.We performed Oc-C7 fixation, C1 laminectomy, and C3-C7 laminoplasty.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Tokyo Women's Medical University, Tokyo, Japan.

ABSTRACT
Destructive spondyloarthropathy (DSA) has been reported in patients undergoing long-term hemodialysis. Cervical spinal lesions, including those of the upper cervical spine, are reported to be some of the most common. To our knowledge, we report for the first time, a case of atlanto-occipital subluxation requiring surgical treatment due to severe myelopathy and nuchal pain in a patient undergoing long-term hemodialysis. The patient was a 66-year-old woman who had undergone hemodialysis for 40 years. She visited our hospital due to an acute progression of gait disturbance and severe nuchal pain. Computed tomography showed posterior subluxation of the atlanto-occipital joints. DSA was also observed in the lower cervical spine. Magnetic resonance imaging showed spinal canal stenosis at both the upper and lower cervical levels. We performed Oc-C7 fixation, C1 laminectomy, and C3-C7 laminoplasty. We first recognized that the atlanto-occipital subluxation was caused by the extremely long-term, in this case, 40 years, hemodialysis.

No MeSH data available.


Related in: MedlinePlus