Eur J Anat, 20 (1): 87-91 (2016)

Spur on posterior arch of atlas with fatal spinal cord compression - a case report

Asit K. Sikary¹, Tony G. Jacob², Mohan S. Meena¹

¹Department of Forensic Medicine, All India Institute of Medical Sciences, New Delhi, India, ²Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India

ABSTRACT The atlas vertebra has many developmental variations in its structure, mainly on its posterior arch with prevalence varying from 0.69% to 4%. It includes a spur on the anterior arch, a thickened anterior arch, posterior pointiculus and incomplete posterior arch among others. Some of the variations are associated with spinal stenosis, such as hypoplastic arch and ossification of the posterior longitudinal ligament. The anomalies are generally asymptomatic, but occasionally cause neck pain, and rarely myelopathy. In the case reported here, a spur was present in the midline on the anterior surface of the posterior arch of the atlas. This led to gradual compression of the cervical spinal cord with progressive quadriplegia, numbness and death. Myelopathy was confirmed by histopathology.

Keywords: Atlas vertebra, Anterior arch, Posterior arch, Cranio-vertebral junction, Atlas spur, Spinal canal stenosis, Myelopathy