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Recovery After Cervical Decompression Surgery for the Treatment of Crowned Dens Syndrome Causing Progressive Neurological Decline: A Case Report

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  1. American Spinal Injury Association, Atlanta, GA. ASIA Exam Sheet for International Standards for Neurological Classification of Spinal Cord Injury. Available at: Accessed January 16, 2013.

  2. 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.

    Article  PubMed Central  PubMed  Google Scholar 

  3. 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.

    Article  CAS  PubMed  Google Scholar 

  4. 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.

    CAS  PubMed  Google Scholar 

  5. Chang EY, Lim WY, Wolfson T, et al. Frequency of atlantoaxial calcium pyrophosphate dihydrate deposition at CT. Radiology. 2013.

  6. 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.

    Article  PubMed  Google Scholar 

  7. Goto S, Umehara J, Aizawa T, Kokubun S. Crowned Dens syndrome. J Bone Joint Surg Am. 2007; 89: 2732-2736.

    Article  PubMed  Google Scholar 

  8. 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.

    Article  Google Scholar 

  9. 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.

    PubMed  Google Scholar 

  10. Li XF, Dai LY. Acute central cord syndrome: injury mechanisms and stress features. Spine (Phila Pa 1976). 2010; 35: E955-64.

    Article  Google Scholar 

  11. 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.

    Article  PubMed  Google Scholar 

  12. Magarelli N, Simone F, Amelia R, et al. MR imaging of atlantoaxial joint in early rheumatoid arthritis. Radiol Med. 2010; 115: 1111-1120.

    Article  CAS  PubMed  Google Scholar 

  13. Nowak DD, Lee JK, Gelb DE, Poelstra KA, Ludwig SC. Central cord syndrome. J Am Acad Orthop Surg. 2009; 17: 756-765.

    PubMed  Google Scholar 

  14. Pfeiffer Zehnder C. Acute neck pain in an elderly patient. Praxis (Bern 1994). 2010; 99: 1295-1299.

    Article  CAS  Google Scholar 

  15. 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.

    CAS  PubMed  Google Scholar 

  16. 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.

    Article  CAS  PubMed  Google Scholar 

  17. Wasserman BR, Moskovich R, Razi AE. Rheumatoid arthritis of the cervical spine—clinical considerations. Bull NYU Hosp Jt Dis. 2011; 69: 136-148.

    PubMed  Google Scholar 

  18. Werner BC, Shen FH, Shimer AL (2013) Primary cervical amyloidoma: A case report and review of the literature. Spine J.

  19. 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

  20. 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.

    Article  PubMed  Google Scholar 

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Conflict of Interest:

Alexander Aichmair, MD, Richard J. Herzog, MD, Giorgio Perino, MD, and Darren R. Lebl, MD have declared that they have no conflict of interest.

Human/Animal Rights:

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).

Informed Consent:

Informed consent was waived from all patients for being included in the study.

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Correspondence to Alexander Aichmair MD.

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Aichmair, A., Herzog, R.J., Perino, G. et al. Recovery After Cervical Decompression Surgery for the Treatment of Crowned Dens Syndrome Causing Progressive Neurological Decline: A Case Report. HSS Jrnl 10, 83–87 (2014).

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