Cervical myelopathy involving os odontoideum and retro-odontoid cyst treated with Harms C1–C2 arthrodesis

An episode of acute decompensation of cervical myelopathy occurred after an injury without fracture of an os odontoideum associated with a compressive retro-odontoid cyst. The 51-year-old female patient presented Fränkel C, Nurick grade 4 neurological status and pyramid syndrome. The initial MRI demonstrated an intramedullary T2 hyperintense signal in the context of spinal cord narrowing. The retro-odontoid cyst demonstrates atlantoaxial instability related to the os odontoideum. Harms C1–C2 arthrodesis without laminectomy was performed and the cyst disappeared completely. Spinal cord decompression was thus obtained on the MRI taken 3 months later. Neurological recovery was complete and continued at 1 year.