Spinal canal stenosis at the level of the atlas: case report.

We describe a rare case of cervical canal stenosis at the level of the atlas, presenting with cervical myelopathy as an initial symptom. A 55-year-old man was admitted to our hospital with a 4-month history of gait disturbance and clumsiness in both hands. He had no history of trauma, and showed left-sided hemihyperesthesia and mild quadriplegia with exaggerated deep tendon reflexes. Plain cervical tomography revealed marked spinal canal stenosis, with the diameter of 8.0 mm at the level of the atlas. Magnetic resonance imaging demonstrated severe compression of the spinal cord at the atlas, with an extensive high intensity area indicating edema on T2-weighted images. The patient showed an excellent recovery after laminectomy of the atlas combined with decompression of the lower posterior fossa of the foramen magnum and dural plasty.