Unexpected Persistent Dentocentral Synchondrosis of C2

Publication date: March 2018
Source:World Neurosurgery, Volume 111
Author(s): Shahed Nalla, Esther Blanco-Perez, Federico Mata-Escolano, Susanna Llido, Juan A. Sanchis-Gimeno
BackgroundThe persistence of synchondrosis in adulthood can confound diagnostic decisions made during patient management.Case DescriptionA 59-year-old woman who presented neck pain, acute headache, and acute cervical myelopathy symptoms after suffering whiplash grade 3 in a car rear-end impact underwent a conventional radiologic study that revealed no fracture and no anatomic spine variations. The magnetic resonance imaging study revealed no spinal cord intensity signal changes, but it showed a persistent (remnant) dentocentral synchondrosis that was undetected in a previous conventional radiographic evaluation.ConclusionsThe localization and level of the remnant of the dentocentral synchondrosis are extremely important from the clinical viewpoint because of odontoid and C2 fractures. Neurosurgeons should thus be aware of the possible presence of a persistent (remnant) C2 dentocentral synchondrosis in adult subjects in order to avoid misdiagnosis with C2 fracture.



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