SPONTANEOUS FRACTURE OF THE ODONTOID PROCESS IN A PATIENT WITH ANKYLOSING-SPONDYLITIS - NONUNION RESPONSIBLE FOR COMPRESSION OF THE UPPER CERVICAL CORD

Tetraparesis due to a spontaneous fracture of the base of the odontoid process occurred in a patient with undiagnosed, advanced ankylosing s pondylitis. Few cases of insufficiency fractures of the proximal cervi cal spine in patients with loss of spinal mobility have been reported in the literature. The pathologic lesions that can cause severe neurol ogic compromise are reviewed. Because functional impairment and neurol ogic loss are common even after surgical decompression and stabilizati on, these lesions should be looked for during a careful physical evalu ation followed by appropriate investigations.