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Research ArticleCervical Spine

Cervical Myelopathy Secondary to Bilateral Atlantoaxial Pseudoarticulations in Rheumatoid Arthritis: A Case Report

Pragadesh Natarajan, Vignaraja Thirunavukarasu and Yingda Li
International Journal of Spine Surgery March 2025, 8735; DOI: https://doi.org/10.14444/8735
Pragadesh Natarajan
1 Faculty of Medicine, University of New South Wales (UNSW), Sydney, Australia
2 Department of Neurosurgery, Westmead Hospital, Western Sydney Local Health District, Sydney, Australia
BSc (Med) Hons, MD
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  • For correspondence: pragadeshnat9@hotmail.com
Vignaraja Thirunavukarasu
2 Department of Neurosurgery, Westmead Hospital, Western Sydney Local Health District, Sydney, Australia
MBBS, BSc, MPhil (Med)
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Yingda Li
2 Department of Neurosurgery, Westmead Hospital, Western Sydney Local Health District, Sydney, Australia
3 Faculty of Medicine, University of Sydney, Camperdown, Australia
MBBS (Melb), BMedSc, PGDipSurgAnat, FRACS (Neuro)
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    Figure 1

    Preoperative magnetic resonance imaging sequences of the patient’s cervical spine demonstrating cervical myelopathy due to posterolateral cord compression related to bilateral pseudoarticulations. (A) T2-weighted sagittal view. (B) T2-weighted axial view.

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    Figure 2

    Preoperative 3-dimensional reconstruction computed tomography (CT) images demonstrating bilateral pseudoarticulations (white arrows). (A) CT dorsal view of C1 to C2 vertebrae. (B) Sagittal view of C1 to C7 vertebra. Images reproduced with permission from Medacta Australia.

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    Figure 3

    (A) Intraoperative findings of bilateral C2 pseudoarticulations with occiput superiorly (star) and C2 spinous process inferiorly (blue arrow). (B) Close-up view demonstrating the presence of synovial membranes as well as synovial fluid adjacent to inferior and superior pseudoarticulations bilaterally (green triangle). The majority of the C1 posterior arch was removed in previous laminectomy surgery.

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    Figure 4

    Day 7 postoperative erect x-ray images. (A) Lateral erect view. (B) Odontoid view.

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International Journal of Spine Surgery: 19 (S2)
International Journal of Spine Surgery
Vol. 19, Issue S2
1 Apr 2025
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Cervical Myelopathy Secondary to Bilateral Atlantoaxial Pseudoarticulations in Rheumatoid Arthritis: A Case Report
Pragadesh Natarajan, Vignaraja Thirunavukarasu, Yingda Li
International Journal of Spine Surgery Mar 2025, 8735; DOI: 10.14444/8735

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Cervical Myelopathy Secondary to Bilateral Atlantoaxial Pseudoarticulations in Rheumatoid Arthritis: A Case Report
Pragadesh Natarajan, Vignaraja Thirunavukarasu, Yingda Li
International Journal of Spine Surgery Mar 2025, 8735; DOI: 10.14444/8735
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Keywords

  • rheumatoid arthritis
  • cervical myelopathy
  • pseudoarthrosis
  • pseudoarticulation
  • C1-2 fusion

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