Split atlas
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View Craig Hacking's current disclosuresAt the time the article was last revised Craig Hacking had no recorded disclosures.
View Craig Hacking's current disclosures- bipartite atlas
Split or bipartite atlas is the rare congenital anomaly where the atlas is split into two halves by fusion defects in both the anterior and posterior arches. The osseous defects are spanned by fibrous tissue.
They are usually asymptomatic and found incidentally on spinal imaging. Patients may have neck pain and rarely develop cervical myelopathy.
The anterior arch defect is mostly in the midline and usually smaller than the posterior arch defect, which is almost always in the midline.
Care should be taken to avoid misdiagnosing a Jefferson fracture, noting that fusion defects will have broad or tapered osseous margins that are rounded and well-corticated.
References
- 1. Frick BS, Figiel JH, Rominger M. ["Split atlas" - a rare congenital malformation of the anterior and posterior atlantic arc]. (2007) RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin. 179 (8): 855-6. doi:10.1055/s-2006-927343 - Pubmed
- 2. Ramdhan, RC, et al. The Split Atlas Anomaly: A Comprehensive Review (2017) Spine Scholar 1:37-44.
- 3. Bonneville F, Jacamon M, Runge M, Jacquet G, Bonneville JF. Split atlas in a patient with odontoid fracture. (2004) Neuroradiology. 46 (6): 450-2. doi:10.1007/s00234-004-1189-z - Pubmed
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