ABSTRACT
Os odontoideum is a rare condition, first described in the 19th century. It is an independent ossicle of variable size separated from the hypoplastic dens. It is classified into two anatomic types, dystopic and orthotopic. The condition is commonly seen in males in their second and third decades, and may be found incidentally or manifests as cervical myelopathy. Descriptions of the causes, natural history, optimal management, and surgical interventions are limited and a subject of debate. We report a fifty-seven-year-old female who presented with features of severe progressive cervical myelopathy and severe neck pain, dizziness, and gait imbalance. Imaging revealed os odontoideum with myelomalacia. She underwent C1-C2 closed reduction and posterior fusion using Goel and Harms technique. Symptomatic improvement in terms of pain and balance was observed postoperatively and during follow-up