Recovery After Cervical Decompression Surgery for the Treatment of Crowned Dens Syndrome Causing Progressive Neurological Decline: A Case Report
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Traumatic injury to the spinal cord can be divided into complete and incomplete subtypes, based on complete or partial absence of neurologic function below the level of injury. Incomplete spinal cord injury has been shown to occur following cervical hyperextension or flexion injury in the setting of preexisting cervical spinal stenosis. The broad spectrum of symptoms from incomplete spinal cord injury includes weakness and sensory deficits potentially affecting upper and lower extremities, as well as bowel, bladder, and sexual dysfunction in severe cases. The most common type of incomplete spinal cord injury is central cord syndrome, which is characterized by a more severely impaired motor function in the upper than the lower extremities [1, 8, 10, 13, 16]. Progressive neurological deficit has also been reported to occur due to C1–C2 pannus formation in the setting of rheumatic disease [4, 12, 17, 19, 20].
Crowned dens syndrome (CDS) is a rare but known cause of decreased ce ...
- American Spinal Injury Association, Atlanta, GA. ASIA Exam Sheet for International Standards for Neurological Classification of Spinal Cord Injury. Available at: http://www.asia-spinalinjury.org/elearning/ISNCSCI_Exam_Sheet_r4.pdf. Accessed January 16, 2013.
- Ali S, Hoch M, Dadhania V, Khurana JS. CPPD crowned dens syndrome with clivus destruction: a case report. J Radiol Case Rep. 2011; 5: 30-37. CrossRef
- Baysal T, Baysal O, Kutlu R, Karaman I, Mizrak B. The crowned dens syndrome: a rare form of calcium pyrophosphate deposition disease. Eur Radiol. 2000; 10: 1003-1005. CrossRef
- Boden SD, Dodge LD, Bohlman HH, Rechtine GR. Rheumatoid arthritis of the cervical spine. A long-term analysis with predictors of paralysis and recovery. J Bone Joint Surg Am. 1993; 75: 1282-1297.
- Chang EY, Lim WY, Wolfson T, et al. Frequency of atlantoaxial calcium pyrophosphate dihydrate deposition at CT. Radiology. 2013.
- Chen L, Yang H, Yang T, Xu Y, Bao Z, Tang T. Effectiveness of surgical treatment for traumatic central cord syndrome. J Neurosurg Spine. 2009; 10(1): 3-8. CrossRef
- Goto S, Umehara J, Aizawa T, Kokubun S. Crowned Dens syndrome. J Bone Joint Surg Am. 2007; 89: 2732-2736. CrossRef
- Ishida Y, Tominaga T. Predictors of neurologic recovery in acute central cervical cord injury with only upper extremity impairment. Spine (Phila Pa 1976). 2002; 27: 1652-8. discussion 1658. CrossRef
- Ito K, Aoyama T, Hara Y, Horiuchi T, Hongo K. Acute neck pain caused by calcium pyrophosphate dehydrate deposition in the transverse ligament of the atlas: a case report. No Shinkei Geka. 2011; 39: 769-772.
- Li XF, Dai LY. Acute central cord syndrome: injury mechanisms and stress features. Spine (Phila Pa 1976). 2010; 35: E955-64. CrossRef
- Lin SH, Hsieh ET, Wu TY, Chang CW. Cervical myelopathy induced by pseudo-gout in ligamentum flavum and retro-odontoid mass: a case report. Spinal Cord. 2006; 44: 692-694. CrossRef
- Magarelli N, Simone F, Amelia R, et al. MR imaging of atlantoaxial joint in early rheumatoid arthritis. Radiol Med. 2010; 115: 1111-1120. CrossRef
- Nowak DD, Lee JK, Gelb DE, Poelstra KA, Ludwig SC. Central cord syndrome. J Am Acad Orthop Surg. 2009; 17: 756-765.
- Pfeiffer Zehnder C. Acute neck pain in an elderly patient. Praxis (Bern 1994). 2010; 99: 1295-1299. CrossRef
- Salaffi F, Carotti M, Guglielmi G, Passarini G, Grassi W. The crowned dens syndrome as a cause of neck pain: clinical and computed tomography study in patients with calcium pyrophosphate dihydrate deposition disease. Clin Exp Rheumatol. 2008; 26: 1040-1046.
- Schneider RC, Cherry G, Pantek H. The syndrome of acute central cervical spinal cord injury; with special reference to the mechanisms involved in hyperextension injuries of cervical spine. J Neurosurg. 1954; 11: 546-577. CrossRef
- Wasserman BR, Moskovich R, Razi AE. Rheumatoid arthritis of the cervical spine—clinical considerations. Bull NYU Hosp Jt Dis. 2011; 69: 136-148.
- Werner BC, Shen FH, Shimer AL (2013) Primary cervical amyloidoma: A case report and review of the literature. Spine J.
- Yonezawa I, Okuda T, Won JH, Sakoda J, Nakahara D, Nojiri H, Muto O, Momomura R, Kaneko K (2012) Retrodental Mass in Rheumatoid Arthritis. J Spinal Disord Tech
- Younes M, Belghali S, Kriaa S, et al. Compared imaging of the rheumatoid cervical spine: prevalence study and associated factors. Joint Bone Spine. 2009; 76: 361-368. CrossRef
- Recovery After Cervical Decompression Surgery for the Treatment of Crowned Dens Syndrome Causing Progressive Neurological Decline: A Case Report
HSS Journal ®
Volume 10, Issue 1 , pp 83-87
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Industry Sectors
- Author Affiliations
- 1. Hospital for Special Surgery, Department of Orthopedic Surgery, Spine and Scoliosis Service, 535 East 70th Street, New York, NY, 10021, USA
- 2. Hospital for Special Surgery, Department of Radiology and Imaging, 535 East 70th Street, New York, NY, 10021, USA
- 3. Hospital for Special Surgery, Department of Pathology and Laboratory Medicine, 535 East 70th Street, New York, NY, 10021, USA