Altano-axial subluxation with torticollis secondary to Langerhans cell histocytosis

• Published in: Interdisciplinary neurosurgery : Advanced techniques and case management 2017-12, Vol.10, p.101-103
• Main Authors: Chua, Joshua Y., Ling, Ji Min, Lian, Derrick W.Q., Chan, Mei Yoke, Low, David C.Y., Low, Sharon Y.Y.
• Format: Article
• Language: English
• Subjects: Atlanto-axial subluxation; Langerhans cell histocytosis; Torticollis
• ISSN: 2214-7519; 2214-7519
• DOI: 10.1016/j.inat.2017.07.015

Langerhans Cell Histiocytosis is a rare disease featuring aberrant proliferation of dendritic cells that can infiltrate the bony skeleton. The authors report a case of six-year-old female presenting with torticollis. She was found to have extensive lytic LCH lesions in the cranio-cervical junction, causing atlanto-axial rotatory subluxation. Decision was made for a non-surgical approach to treat the patient. She was placed in a Halo brace, and given concomitant chemotherapy. Post-treatment imaging demonstrated near-complete reconstitution of the skeleton affected by LCH. This case highlights the feasibility of non-surgical treatment in selected LCH patients at high-risk of spinal instability. •LCH is a disease featuring aberrant proliferation of dendritic cells that can infiltrate the bony skeleton.•The authors present a six-year-old with LCH lesions in the cranio-cervical junction, causing atlanto-axial subluxation.•Decision was made for a non-surgical approach. She was placed in a Halo brace, and given concomitant chemotherapy.•This approach was successful with resolution of her lesions on follow-up imaging.•This case highlights the feasibility of non-surgical treatment in selected LCH patients at high-risk of spinal instability.