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Journal of Trauma and Injury 2013;26(1):30-33.
Congenital Defects of the Atlantal Arch Presenting Incidentally after Trauma
Seung Taeck Rhee
Department of Surgery, Mok-Po Jung Ang General Hospital, Mokpo, Korea. stlee@mail.daebul.ac.kr
외상 후 우연히 발견된 고리뼈 활의 선천적 결손 (증례 보고)
이 승 택
목포중앙병원 외과
Received: 8 February 2013   • Revised: 10 February 2013   • Accepted: 12 February 2013
Abstract
A 55-year-old woman was seen in the emergency department with posterior neck pain and a headache after a traffic accident. Physical examination revealed tenderness on palpation over the posterior skull and a midline spinous process of the cervical spine without neurologic deficit. A plain radiograph of the cervical spine demonstrated the absence of the lateral portion of the posterior arch of the atlas and very lucent shadowing of the anterior midline of the atlas, suggesting a fracture of the anterior arch. On three-dimensional computed tomography (CT) of the cervical spine, anterior and posterior bony defects of the atlas were noted. Well-corticated defects were noted with sclerotic change and with no evidence of soft tissue swelling adjacent to the bony discontinuities, consistent with a congenital abnormality. With conservative therapy, the patient gradually showed a lessening of the midline tenderness. Careful investigation with radiography or CT is needed for these patients to avoid confusion with a fracture, because these patients seldom need surgical treatment.
Key Words: Atlas; Neurologic deficit; Congenital abnormality; Computed tomography
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