Paget's Cervical Disease with Spinal Cord Compression and Atlantoaxial Instability: Case Report

Abstract

Authors report about the case of a 65-year-old woman presenting with a polyostotic Paget's disease, with axis, lumbar, and calcaneum involvement. The C2 vertebral lesion was responsible for spinal cervical cord compression and atlantoaxial instability because of a pathological odontoid peg fracture. The patient was operated on by a posterior approach allowing spinal cord decompression, pathological tissue sampling, and C0-C4 stabilization. Pathological examination confirmed the radiological diagnosis of Paget's disease and the biphosphonate therapy was started. Radiological follow-up showed a good craniocervical stability and an unchanged axis lesion. Even if treatment of pagetic spinal stenosis symptoms should start with medical therapy, surgery can sometimes be preferred to treat neural compression due to spinal instability.