Novel Approach for Posterior C1 Double-door Laminoplasty with Atlantoaxial Fusion in Progressive Cervical Myelopathy: A Case Report

INTRODUCTION: This report describes a novel approach for spinal cord decompression using C1–C2 atlantoaxial fusion with bilateral C1 hinge laminoplasty. Hypothetically, this approach ensures that the stenotic spine is decompressed while simultaneously retaining C1 density for subsequent fixation. Similar techniques have been used in previous case reports for revision procedures or for fusions beyond the atlantoaxial joint. CASE REPORT: Here, an 83-year-old man with psoriatic arthritis, instability, paresthesia, and motor dysfunction regained strength without symptom progression at 7 months follow-up from cervical spine surgery. This patient had no prior surgical interventions at C1–C2. The pre-operative modified Japanese Orthopedic Association scale score was a 9 preoperatively and a 10 at final post-operative follow-up. CONCLUSION: This case provides an alternative to anterior cervical discectomy with fusion, laminectomy, or laminoplasty for progressive myelopathy relief in the geriatric population. Neurosurgeons and orthopedic spine surgeons alike may benefit from utilizing this technique, potentially reducing the occurrence of reoperations or revisions due to instability and or cervical stenosis.