RESUMEN
CASE: A healthy 5-year-old boy presented with a gradual onset of headaches and acute global right-sided weakness over 10 days. The work-up revealed unstable os odontoideum leading to multiple posterior circulation infarcts with vertebral artery dissection. He underwent antiplatelet therapy, cervical collar immobilization, and delayed occiput to C2 posterior spinal fusion and instrumentation with iliac crest autograft. At 2-year follow-up, the patient had a solid fusion mass, appropriate cervical alignment, and was without neurologic sequelae. CONCLUSION: This case adds to a sparse body of literature in the management of vertebral artery dissection with vertebrobasilar insufficiency secondary to unstable os odontoideum.
Asunto(s)
Articulación Atlantoaxoidea , Vértebra Cervical Axis , Apófisis Odontoides , Fusión Vertebral , Disección de la Arteria Vertebral , Masculino , Humanos , Preescolar , Disección de la Arteria Vertebral/complicaciones , Disección de la Arteria Vertebral/diagnóstico por imagen , Apófisis Odontoides/cirugía , Articulación Atlantoaxoidea/cirugía , InfartoRESUMEN
CASE: A 22-year-old woman with Klippel-Feil syndrome who underwent cervical disc arthroplasty (CDA) presented 3 months postoperatively with worsening neck pain and radiculopathy. Work-up was negative for infection, but single-photon emission computed tomography revealed increased metabolic activity in the vertebral body below the implant. During revision, the implant was grossly loose and multiple cultures grew Cutibacterium acnes. She was treated with an antibiotic course and conversion to anterior fusion without recurrence. CONCLUSION: This report highlights the rare presentation of an early periprosthetic infection after CDA caused by C. acnes.