case_images: PMC10823814_01
case_images: Lateral view of a cervical X-ray acquired at a local hospital. There was no atlantoaxial subluxation or vertical subluxation.
case_images: JOCR-14-98-g001.jpg
case_images: PMC10823814_01_JOCR-14-98-g001.jpg
case_images: F1
case_images: A cervical X-ray showed only degenerative findings (Fig. 1) and no instability, and he was treated conservatively for cervical osteoarthritis.
case_images: Computed tomography (CT) before surgery. (a) Coronal CT showed osteolysis around the odontoid process, including the atlantooccipital and atlantoaxial joints (black arrows). (b) Sagittal CT showed vertical subluxation.
case_images: JOCR-14-98-g002.jpg
case_images: PMC10823814_01_JOCR-14-98-g002.jpg
case_images: F2
case_images: The lateral view of the cervical X-ray showed AAS, while CT showed osteolysis around the odontoid process, including the atlantooccipital and atlantoaxial joints, causing VS (Fig. 2).
case_images: Magnetic resonance imaging (MRI) before surgery. (a) Sagittal T2-weighted image showed spinal cord and brainstem compression at the C1/2 level. (b) Sagittal T2-weighted image showed fluid in the right lateral atlantoaxial joint (white arrow). (c) Gadolinium-enhanced MRI showed enhancement around the odontoid process (black arrows).
case_images: JOCR-14-98-g003.jpg
case_images: PMC10823814_01_JOCR-14-98-g003.jpg
case_images: F3
case_images: Gadolinium-enhanced MRI showed enhancement around the odontoid process (Fig. 3).
case_images: Cervical X-ray and CT showed bone union between the occipital-cervical spine (black arrows) at 6 months after surgery. (a) Lateral view of the cervical X-ray. (b) Coronal view of the cervical CT. (c) Sagittal view of the cervical CT.
case_images: JOCR-14-98-g004.jpg
case_images: PMC10823814_01_JOCR-14-98-g004.jpg
case_images: F4
case_images: X-ray and CT showed bone union between the O-C4 spine at 6 months after surgery (Fig. 4).