Axial osteochondroma causing myelopathy – A technical note and discussion on atlantoaxial fusion following C2 laminectomy

Osteochondromas are one of the commonest benign bone tumours, but are rarely found in the spine. Cord compression due to these lesions is even rarer. We describe a case of a C2 lamina osteochondroma causing cord compression in a 20 year old patient who presented with progressive myelopathy. We report on the technical aspects of the operation which resulted in a good decompression and complete excision. Post-operatively the patient made an uncomplicated recovery. We recommend spinal cord monitoring as routine for such procedures. However, whether or not fusion is necessary following a C2 laminectomy is unclear. Given the unique nature of the atlantoaxial joint, we elected to do this, but the literature is uncertain on the biomechanical aspects of this subject. Biomechanical data exists on single and multi-level subaxial laminectomies, but we argue that dedicated studies into post C2 laminectomy biomechanics should be undertaken.