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Congenital Anomalies of the Odontoid

Types

  • Aplasia
    • rare
  • Hypoplasia
    • eg in achondroplasia, spondyloepiphyseal dysplasia
  • Os Odontoideum
    • may be congenital or traumatic

Clinically

  • instability of atlanto- axial
  • joint pain
  • torticollis
  • neurologic compromise
  • vertebral artery compression seizures, mental deterioration, syncope, vestibular disturbances

Investigations

  • flexion - extension films
    • show hypermobility- atlanto-dens interval more than 5mm in children
  • MRI
    • shows cord damage
  • CT
    • demonstrate the degree of displacement

Treatment

  • C1-2 fusion
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