BACKGROUND: Congenital partial anterior arch defect of the atlas is extremely rare. It could be found as an incidental radiological finding or @entity1 can present with @entity51 after @entity135 . OBJECTIVE: To describe an extremely rare presentation of anterior midline cleft at the atlas and @entity9807 with symptomatic @entity1347 . This report includes a feasible hypothesis for the development of this anomaly on the basis of previous hypotheses and surgical findings. METHODS: A 46-year-old female presented with a 6-day history of right limbs numb and left upper and lower extremities paraparesis (Frankel D). Radiographs of the cervical spine showed @entity9807 . Computed tomography subsequently revealed partial midline absence of the anterior arch of the atlas and the odontoid tip ahead of the anterior arch of the atlas. Magnetic resonance imaging showed that the cervical dura was compressed by the remnant of anterior arch of the atlas. The @entity1 underwent Gardner-Wells tong traction and surgery of occipitocervical fusion with autogenous iliac bone graft because she had definite neurological symptom and @entity9807 . RESULTS: @entity9807 was confirmed with fluoroscopic X-ray evaluation by bed, her @entity51 was resolved from Frankel D to E, and numb of right limbs completely disappeared 6 days postoperation. No instability has been observed during 2-year follow-up. CONCLUSION: We describe the association between @entity1745 and @entity154 of the anterior arch of the atlas with symptomatic @entity1347 . Both computed tomography and magnetic resonance image were required to demonstrate the bony configuration and @entity1745 . And Gardner-Wells tong traction and surgery of occipitocervical fusion with autogenous iliac bone graft were effective as a treatment for this @entity1745 caused by the remnant of anterior arch of the atlas.

Congenital anterior midline cleft of the atlas and posterior atlanto-occipital fusion associated with symptomatic XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity135 :: ('MESH:D006258', 'Disease') :: ['head or neck trauma'] @entity154 :: ('MESH:D000013', 'Disease') :: ['congenital defect'] @entity1347 :: ('MESH:C537775', 'Disease') :: ['anterior atlantoaxial subluxation'] @entity51 :: ('MESH:D009461', 'Disease') :: ['neurological deficit'] @entity1745 :: ('MESH:D013117', 'Disease') :: ['cord compression', 'compressive myelopathy'] @entity9807 :: ('MESH:C538196', 'Disease') :: ['congenital posterior atlanto-occipital fusion', 'anterior atlantoaxial subluxation with congenital posterior atlanto-occipital fusion', 'Atlantoaxial reduction']
@entity1347 :: (MESH:C537775,Disease) :: ['anterior atlantoaxial subluxation']
