A 72-year-old male, with no relevant medical history and under treatment with solids in the extremities accompanied by chronic neck pain, who came to the emergency department complaining of significant gait disturbance and progressive loss of strength 6 months.
Physical examination revealed left spastic hemiparesis, generalized hyperreflexia, positive Romberg sign and ataxia.
The NMR shows a thickening of soft tissues around the odontoid apophysis conditioning a severe stenosis of the spinal canal, especially of the left half, with a predominance of anterior proliferative obliterations C2- bulbomedular junction C6.
1.
Under the diagnosis of Forestier's disease, the patient was initially submitted to surgery by transoral approach, with resection of the anterior arch of the atlas and the odontoid process without neurological improvement. An external cervical approach was performed.
Postoperative evolution showed progressive clinical improvement of dysphagia and hemiparesis with absence of respiratory symptoms.
