Unusual cause of high cervical myelopathy-C1 arch stenosis

INTRODUCTION: High cervical myelopathy can be rarely caused by the developmental anomalies of atlas. Patients with C1 arch stenosis can present in early childhood or later in life. In symptomatic patients, posterior decompression at atlas is mandatory. We report the first clinical series of 20 patients of C1 arch stenosis in the English literature. MATERIALS AND METHODS: This is retrospective case series having a cohort of 20 patients with congenital C1 arch stenosis. RESULTS: There were 12 pediatric (age <18 years) and 8 adult patients. Mean age was 22.85 years. Syndromic association was seen in four patients. Following decompressive surgery, these patients noticed a symptomatic improvement. CONCLUSIONS: Isolated C1 arch stenosis is a surgically curable rare cause of high cervical myelopathy and responds well to surgery.