Dysplasia and anomalies of atlas result in pediatric torticollis: A case report and literature review

BACKGROUND: Often, the cause of bony torticollis is difficult to determine, especially in cases of multiple craniovertebral junction anomalies. CASE DESCRIPTION: We report a rare case of a dysplastic C1 vertebra (assimilation to the right occiput and C2, a nonseparated left odontoid, and discontinuity in both anterior and posterior arches of the atlas) in a 6-year-old child with progressive torticollis. Notably, the mechanism of torticollis was not a rotatory subluxation of C1-C2, but differential growth between C1-C2. The child underwent a successful C1-C2 Goel and Harms fusion with reduction/correction of the torticollis. CONCLUSION: Torticollis caused by differential growth between the C1 and C2 vertebrae resulting in a nonrotatory subluxation/torticollis in a 6-year-old child, was successfully managed with a C1-C2 Goel and Harm’s fusion.