Cervical myelopathy due to ossification of the transverse atlantal ligament: A Caucasian case report operated on and literature analysis

Summary One case of cervical myelopathy associated to ossification of transverse atlantalligament (OTAL) and C1 posterior arch hypoplasia in a Caucasian adult female is reported. A 53-year-old femaleaffectedbycervicalmyelopathywastreatedwithC1laminectomyandposteriorarthrodesis. CT scan demonstrated that the distance between ossification of the ligament andanterior cortex of the posterior arch of atlas was 6,2mm leading to consistent space reductionfor spinal cord at this level. Patient underwent spinal cord decompression and fixation withC1 poliaxial screws in lateral masses and two bilateral crossing C2 laminar screws with animprovement of neurological functions at 4-years follow-up. The association between OTAL andC1 hypoplasia was reported in very few cases. The treatment with C1 laminectomy withoutfusion is reported in medical literature with good clinical outcome. Our patient obtained aneurological improvement at midterm follow-up with spinal cord decompression and fusion.© 2012 Elsevier Masson SAS. All rights reserved.