Retro-Odontoid and Retro-C2 Body Pseudotumor, Pannus, and/or Cyst. A Study Based on Analysis of 63 Cases
| Autor: | Atul Goel, Abhidha Shah, Akshay Hawaldar, Apurva Prasad, Hardik Darji |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Joint Instability Male medicine.medical_specialty Pannus Conservative Treatment Resection 03 medical and health sciences 0302 clinical medicine Odontoid Process medicine Bone Cysts Humans Cyst Transverse dimension Torticollis Retrospective Studies Odontoid process Spinal Neoplasms business.industry medicine.disease Magnetic Resonance Imaging Internal Fixators Spinal Fusion Atlanto-Axial Joint Atlantoaxial instability 030220 oncology & carcinogenesis Cervical Vertebrae Surgery Female sense organs Neurology (clinical) Radiology business Tomography X-Ray Computed Spinal Cord Compression 030217 neurology & neurosurgery Atlantoaxial fixation |
| Zdroj: | World neurosurgery. 151 |
| ISSN: | 1878-8769 |
| Popis: | Objective The potential significance of relationship of atlantoaxial instability with retro-odontoid pseudotumor, pannus, and/or cyst (RPC) is analyzed. Methods We searched the database of patients with craniovertebral junction–related instability treated by atlantoaxial fixation from January 2000 to March 2020. We identified 63 patients in whom there was an RPC in the region posterior to the odontoid process or posterior to the posterior aspect of the C2 body. Results The RPC was solid in 10 patients, predominantly cystic in 39 patients, and had both solid and cystic components in 14 patients. The vertical dimension of the RPC varied from 4.5 to 10.5 mm (average, 7.9 mm) and the transverse dimension ranged from 2 to 5.2 mm (average, 3.4 mm). In 51 patients, the RPC was in the midline and in 9 patients, it was eccentric in location. In 38 patients, there was erosion of the C2 body adjoining the RPC. Analysis of investigations showed that in 100% of patients, the dome of the RPC was in line with the most susceptible point of potential bone compression of neural structures. The RPC was eccentric in location in 9 patients presenting with torticollis. RPC indicated the presence of atlantoaxial instability even when there were no other positive and validated radiologic indicators. After atlantoaxial stabilization, the RPC spontaneously regressed or disappeared. Direct resection of the RPC was neither performed nor was necessary in any case. Conclusions RPCs are secondary consequences of atlantoaxial instability and need not be primarily addressed by surgical resection. Their location suggests that they might have a neural protective function. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect