Spontaneous C1 Anterior Arch Fracture Following C1 Laminectomy for Cervical Meningioma: A Case Report and Review of Literature

Background: A spontaneous C1 anterior arch fracture is a sparsely reported event following a C1 laminectomy done due to various etiologies. Case report: An 82-year-old patient who presented with severe neck pain and instability two years following a C1-C3 laminectomy for the excision of a cervical spinal cord meningioma. Revision of imaging revealed a C1 anterior arch fracture evident already on early post-op MRI. Conclusion: Spontaneous C1 anterior arch fracture following C1-Laminctomy without fusion may be more prevalent than once thought and many cases may go by undiagnosed. Surgeons should take this complication into account when offering and planning such surgery and during post-op followup. Further studies are required in order to establish the exact frequency and to clearly identify the risk factors for the occurrence of post laminectomy anterior arch fractures.