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Case Reports in Orthopedics
Volume 2015, Article ID 142586, 8 pages
http://dx.doi.org/10.1155/2015/142586
Case Report

Atlantoaxial Subluxation due to an Os Odontoideum in an Achondroplastic Adult: Report of a Case and Review of the Literature

Department of Spinal Surgery and Department of Anesthesiology, Pars Advanced and Minimally Invasive Manners Research Center (PAMIM), Pars Hospital Affiliated to Iran University of Medical Sciences, Tehran 1415944911, Iran

Received 5 September 2015; Accepted 25 October 2015

Academic Editor: Paolo Perrini

Copyright © 2015 Abolfazl Rahimizadeh et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The authors report the first example of an adult achondroplastic dwarf with progressive quadriparesis secondary to atlantoaxial subluxation as a consequence of an os odontoideum. Actually, craniocervical region is a frequent site of compression and myelopathy in achondroplasia particularly in children as a result of small foramen magnum and hypertrophied opisthion. Moreover, very rarely in achondroplastic patients, coexistence of atlantoaxial instability as the sequel of os odontoideum can result in further compression of the already compromised cervicomedullary neural tissues, the scenario that has been reported only in five achondroplastic children. Herein, a 39-year-old achondroplastic male suffering such an extremely rare combination is presented. With C1-C2 screw rod instrumentation, atlas arch laminectomy, limited suboccipital craniectomy, and release of dural fibrous bands, reduction, decompression, and stabilization could be achieved properly resulting in steady but progressive recovery.