Anterior atlas fracture following suboccipital decompression for Chiari I malformation

Report of two cases

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✓ Chiari I malformation, a congenital disorder involving downward displacement of the cerebellar tonsils through the foramen magnum, is often treated surgically by performing suboccipital craniectomy and C-1 laminectomy. The authors report two cases in which fracture of the anterior atlantal arch occurred during the postoperative period following Chiari I decompression and C-1 laminectomy causing significant neck pain. The findings indicate that interruption of the integrity of the posterior arch of C-1, iatrogenically or otherwise, confers increased risk of anterior arch fracture. A C-1 fracture should therefore be considered in the differential diagnosis of posterior cervical pain in patients who have previously undergone decompression for Chiari I malformation.

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Contributor Notes

Address reprint requests to: Sean A. Salehi, M.D., Department of Neurological Surgery, 233 East Erie Street, Suite 614, Chicago, Illinois 60611. email: ssalehi@nmff.org.

© AANS, except where prohibited by US copyright law.

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