Atlantoaxial Osteoarthritis: A Well-Established Entity that Remains Frequently Overlooked

Document Type

Article

Abstract

Painful atlantoaxial (C1-2) osteoarthritis (AAOA) has been described over 40 years ago. The condition may cause severe pain symptoms and disability related to the unilateral suboccipital pain and, in some cases, occipital neuralgia. One of the greatest challenges with AAOA is making the diagnosis. Diagnosis is commonly missed or delayed when headaches are treated in isolation or when pain is attributed to subaxial spondylosis. Here we present an illustrative case involving a 67-year-old male presenting with classic painful AAOA. After failing conservative treatments, he was evaluated with morphologic, radiological studies and a diagnostic injection. He was successfully treated with bilateral, navigation guided C1 lateral mass and C2 pedicle screw fixation and fusion. To conclude, when there is clinical suspicion for painful AAOA, providers have numerous diagnostic modalities, including newer hybrid techniques, that can be used to solidify the diagnosis. When conservative efforts fail, C1-2 fusion is an effective and enduring treatment for most patients.

Medical Subject Headings

Aged; Atlanto-Axial Joint (diagnostic imaging, surgery); Cervical Vertebrae (surgery); Humans; Joint Instability (surgery); Male; Neck Pain (diagnostic imaging, etiology, surgery); Osteoarthritis (complications, diagnostic imaging, surgery); Pedicle Screws (adverse effects); Spinal Fusion (methods); Treatment Outcome

Publication Date

1-1-2022

Publication Title

Turkish neurosurgery

ISSN

1019-5149

Volume

32

Issue

2

First Page

336

Last Page

340

PubMed ID

34936073

Digital Object Identifier (DOI)

10.5137/1019-5149.JTN.34884-21.1

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