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Retro-Odontoid Pseudotumor without Atlantoaxial Subluxation or Rheumatic Arthritis
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 an...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Korean Neurotraumatology Society
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5110914/ https://www.ncbi.nlm.nih.gov/pubmed/27857933 http://dx.doi.org/10.13004/kjnt.2016.12.2.180 |
Sumario: | 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. |
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