Skip to main content
Top
Published in: Child's Nervous System 9/2016

01-09-2016 | Review Paper

Bergmann’s ossicle (ossiculum terminale persistens): a brief review and differentiation from other findings of the odontoid process

Authors: Jaspreet Johal, Marios Loukas, Christian Fisahn, Rod J. Oskouian, R. Shane Tubbs

Published in: Child's Nervous System | Issue 9/2016

Login to get access

Abstract

Purpose

The purpose of this paper was to review the literature on Bergmann’s ossicle and provide an overview on its development, etiology, and clinical presentation while also differentiating it from similar structural anomalies.

Methods

A thorough review of the literature available on Bergmann’s ossicle was performed.

Results

Bergmann’s ossicle, also referred to as ossiculum terminale persistens, was defined as a developmental anomaly of the odontoid process in which an ossification center that gives rise to the tip of the dens fails to fuse properly with the body of the axis.

Conclusion

Bergmann’s ossicle is most often a benign condition, although it rarely may present with clinical symptoms such as neck pain and neurological signs. It may be associated with Down’s syndrome and contribute to atlantoaxial instability.
Literature
1.
go back to reference Akobo S, Rizk E, Loukas M, Chapman JR, Oskouian RJ, Tubbs RS (2015) The odontoid process: a comprehensive review of its anatomy, embryology, and variations. Childs Nerv Syst 31:2025–2034CrossRefPubMed Akobo S, Rizk E, Loukas M, Chapman JR, Oskouian RJ, Tubbs RS (2015) The odontoid process: a comprehensive review of its anatomy, embryology, and variations. Childs Nerv Syst 31:2025–2034CrossRefPubMed
2.
go back to reference Pang D, Thompson DN (2011) Embryology and bony malformations of the craniovertebral junction. Childs Nerv Syst 27:523–564CrossRefPubMed Pang D, Thompson DN (2011) Embryology and bony malformations of the craniovertebral junction. Childs Nerv Syst 27:523–564CrossRefPubMed
3.
go back to reference Kim DH, Betz RR, Huhn SL, Newton PO (2008) Surgery of the pediatric spine. Thieme, Stuttgart, pp. 95–96 Kim DH, Betz RR, Huhn SL, Newton PO (2008) Surgery of the pediatric spine. Thieme, Stuttgart, pp. 95–96
4.
go back to reference O’Brien WT Sr, Shen P, Lee P (2015) The dens: normal development, developmental variants and anomalies, and traumatic injuries. J Clin Imaging Sci 5:38CrossRefPubMedPubMedCentral O’Brien WT Sr, Shen P, Lee P (2015) The dens: normal development, developmental variants and anomalies, and traumatic injuries. J Clin Imaging Sci 5:38CrossRefPubMedPubMedCentral
5.
go back to reference Bailey RW, Sherk HH, Dunn EJ, Fielding JW, Long DM, Ono K, Penning L, Stauffer ES (1983) The cervical spine. JB Lippincott Company, Philadelphia, p. 166 Bailey RW, Sherk HH, Dunn EJ, Fielding JW, Long DM, Ono K, Penning L, Stauffer ES (1983) The cervical spine. JB Lippincott Company, Philadelphia, p. 166
6.
go back to reference Yochum TR, Rowe LJ (2004) Essentials of skeletal radiology, 3rd edn. Lippincott Williams & Wilkins, Philadelphia, pp. 272–273 Yochum TR, Rowe LJ (2004) Essentials of skeletal radiology, 3rd edn. Lippincott Williams & Wilkins, Philadelphia, pp. 272–273
7.
go back to reference Goel A, Cacciola F (2011) The craniovertebebral junction: diagnosis, pathology, surgical techniques. Thieme, Stuttgart, pp. 63–64 Goel A, Cacciola F (2011) The craniovertebebral junction: diagnosis, pathology, surgical techniques. Thieme, Stuttgart, pp. 63–64
9.
go back to reference Cattell HS, Filtzer DL (1965) Pseudosubluxation and other normal variations in the cervical spine in children: a study of one hundred and sixty children. J Bone Joint Surg Am 47:1295–1309PubMed Cattell HS, Filtzer DL (1965) Pseudosubluxation and other normal variations in the cervical spine in children: a study of one hundred and sixty children. J Bone Joint Surg Am 47:1295–1309PubMed
10.
go back to reference Anderson LD, D’Alonzo RT (1974) Fractures of the odontoid process of the axis. J Bone Joint Surg Am 56:1663–1674PubMed Anderson LD, D’Alonzo RT (1974) Fractures of the odontoid process of the axis. J Bone Joint Surg Am 56:1663–1674PubMed
11.
go back to reference Sankar WN, Willis BP, Dormans JP, Drummond DS (2006) Os odontoideum revisited: the case for a multifactorial etiology. Spine (Phila Pa 1976) 31:979–984CrossRef Sankar WN, Willis BP, Dormans JP, Drummond DS (2006) Os odontoideum revisited: the case for a multifactorial etiology. Spine (Phila Pa 1976) 31:979–984CrossRef
12.
go back to reference Fielding JW, Hensinger RN, Hawkins RJ (1980) Os odontoideum. J Bone Joint Surg Am 62:376–383PubMed Fielding JW, Hensinger RN, Hawkins RJ (1980) Os odontoideum. J Bone Joint Surg Am 62:376–383PubMed
13.
go back to reference Wollin DG (1963) The os odontoideum: separate odontoid process. J Bone Joint Surg Am 45:1459–1471PubMed Wollin DG (1963) The os odontoideum: separate odontoid process. J Bone Joint Surg Am 45:1459–1471PubMed
14.
go back to reference Smoker WR (1994) Craniovertebral junction: normal anatomy, craniometry, and congenital anomalies. Radiographics 14:255–277CrossRefPubMed Smoker WR (1994) Craniovertebral junction: normal anatomy, craniometry, and congenital anomalies. Radiographics 14:255–277CrossRefPubMed
15.
go back to reference Evarts CM, Lonsdale D (1970) Ossiculum terminale—an anomaly of the odontoid process: report of a case of atlantoaxial dislocation with cord compression. Cleve Clin Q 37:73–76CrossRefPubMed Evarts CM, Lonsdale D (1970) Ossiculum terminale—an anomaly of the odontoid process: report of a case of atlantoaxial dislocation with cord compression. Cleve Clin Q 37:73–76CrossRefPubMed
16.
go back to reference Semine AA, Ertel AN, Goldberg MJ, Bull MJ (1978) Cervical-spinal instability in children with Down syndrome (trisomy 21). J Bone Joint Surg Am 60:649–652PubMed Semine AA, Ertel AN, Goldberg MJ, Bull MJ (1978) Cervical-spinal instability in children with Down syndrome (trisomy 21). J Bone Joint Surg Am 60:649–652PubMed
17.
go back to reference Liang CL, Lui CC, Lu K, Lee TC, Chen HJ (2001) Atlantoaxial stability in ossiculum terminale: case report. J Neurosurg 95(Suppl):119–121PubMed Liang CL, Lui CC, Lu K, Lee TC, Chen HJ (2001) Atlantoaxial stability in ossiculum terminale: case report. J Neurosurg 95(Suppl):119–121PubMed
18.
go back to reference Sherk HH, Nicholson JT (1969) Rotatory atlanto-axial dislocation associated with ossiculum terminale and mongolism: a case report. J Bone Joint Surg Am 51:957–964PubMed Sherk HH, Nicholson JT (1969) Rotatory atlanto-axial dislocation associated with ossiculum terminale and mongolism: a case report. J Bone Joint Surg Am 51:957–964PubMed
19.
go back to reference Burke SW, French HG, Roberts JM, Johnston CE 2nd, Whitecloud TS 3rd, Edmunds JO Jr (1985) Chronic altanto-axial instability in Down syndrome. J Bone Joint Surg Am 67:1356–1360PubMed Burke SW, French HG, Roberts JM, Johnston CE 2nd, Whitecloud TS 3rd, Edmunds JO Jr (1985) Chronic altanto-axial instability in Down syndrome. J Bone Joint Surg Am 67:1356–1360PubMed
20.
go back to reference Kobori M, Takahashi H, Mikawa Y (1986) Atlanto-axial dislocation in Down’s syndrome: report of two cases requiring surgical correction. Spine (Phila Pa 1976) 11:195–200CrossRef Kobori M, Takahashi H, Mikawa Y (1986) Atlanto-axial dislocation in Down’s syndrome: report of two cases requiring surgical correction. Spine (Phila Pa 1976) 11:195–200CrossRef
21.
go back to reference Viswanathan A, Whitehead WE, Luerssen TG, Illner A, Jea A (2009) Orthotopic ossiculum terminale persistens and atlantoaxial instability in a child less than 12 years of age: a case report and review of the literature. Cases J 2:8530CrossRefPubMedPubMedCentral Viswanathan A, Whitehead WE, Luerssen TG, Illner A, Jea A (2009) Orthotopic ossiculum terminale persistens and atlantoaxial instability in a child less than 12 years of age: a case report and review of the literature. Cases J 2:8530CrossRefPubMedPubMedCentral
22.
go back to reference Constantoyannis C, Konstantinou D, Maraziotis T, Dimopoulos PA (2004) Atlantoaxial instability and myelopathy due to an ossiculum terminale persistens. Med Sci Monit 10:63–67 Constantoyannis C, Konstantinou D, Maraziotis T, Dimopoulos PA (2004) Atlantoaxial instability and myelopathy due to an ossiculum terminale persistens. Med Sci Monit 10:63–67
Metadata
Title
Bergmann’s ossicle (ossiculum terminale persistens): a brief review and differentiation from other findings of the odontoid process
Authors
Jaspreet Johal
Marios Loukas
Christian Fisahn
Rod J. Oskouian
R. Shane Tubbs
Publication date
01-09-2016
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 9/2016
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-016-3199-7

Other articles of this Issue 9/2016

Child's Nervous System 9/2016 Go to the issue