Tourette syndrome with cervical instability and expeditious instrumentation failure: A case report and review of the literature

Background: Tourette syndrome is a condition characterized by involuntary motor tics that are often managed with a combination of medication and behavioral therapy. This condition has also been associated with cervical spinal injuries and has been documented as causing multiple cases of progressive myelopathy. In these patients, surgical stabilization may be effective. Case Description: We present a case of a patient with progressive cervical myelopathy with a chronic type II odontoid fracture and Tourette syndrome who had significant hardware failure within 1 month postoperatively due to uncontrolled tics. Conclusion: A failure to sufficiently control the Tourette syndrome led to a failure of the surgical stabilization hardware. Patient education may lead to increased treatment compliance. Treatment guidelines are needed to help practitioners and patients develop individualized and effective treatment programs that not only address the myelopathy but also the tics that contribute to their development.