Retro-Odontoid Pseudotumor without Atlantoaxial Subluxation or Rheumatic Arthritis.
10.13004/kjnt.2016.12.2.180
- Author:
Seung Han YU
1
;
Hyuk Jin CHOI
;
Won Ho CHO
;
Seung Heon CHA
;
In Ho HAN
Author Information
1. Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea. farlateral@hanmail.net
- Publication Type:Case Report
- Keywords:
Odontoid process;
Atlanto-axial joint;
Arthritis, rheumatoid;
Osteoarthritis
- MeSH:
Aged;
Arthritis, Rheumatoid;
Atlanto-Axial Joint;
Biopsy;
Decompression;
Female;
Follow-Up Studies;
Humans;
Ligaments;
Magnetic Resonance Imaging;
Odontoid Process;
Osteoarthritis;
Paresthesia;
Rheumatic Fever*;
Spinal Cord;
Spinal Cord Compression;
Tears;
Upper Extremity
- From:Korean Journal of Neurotrauma
2016;12(2):180-184
- CountryRepublic of Korea
- Language:English
-
Abstract:
We present a case of retro-odontoid pseudotumor (ROP) without rheumatoid arthritis (RA) or atlantoaxial subluxation (AAS). A 76-year-old woman presented with paresthesia and weakness of both lower and upper extremities. She had no laboratory or physical findings of RA. Dynamic X-ray showed no AAS and magnetic resonance imaging (MRI) showed a retro-odontoid mass compressing the spinal cord. Transdural mass debulking and biopsy were performed via minimal left suboccipital craniectomy and C1 hemilaminectomy. Two months after surgery, her symptoms were aggravated. Follow-up MRI visualized mass re-growth and spinal cord compression due to the mass and AAS. Posterior C1-2 fixation was performed without further decompression. Twelve months after posterior fixation, no symptoms were apparent and follow-up MRI showed complete resolution of the ROP with C1-2 bony fusion. The ROP with C1-2 instability might be completely resolved only C1-2 fusion without decompression. Furthermore, we speculated that osteoarthritis of C1-2 itself causes a partial tear or degradation of the transverse ligament, that induced formation of ROP.
