Enlarging retro-odontoid pseudotumor after expanding cervical laminoplasty in the presence of kyphosis

Matsumoto, Tomoyuki; Takada, Shozo; Tsujimoto, Kazuo; Ozaki, Takuma; Ishimoto, Katsuhiko; Tsumura, Nobuhiro; Shiba, Ryoichi; Kurosaka, Masahiro

doi:10.1016/j.spinee.2005.08.010

Cited by 23 publications

(14 citation statements)

References 11 publications

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“…In contrast, an atypical mass at the posterior of the odontoid process not associated with underlying disease has been reported to be a reactive fibrocartilaginous mass induced by chronic subluxation in the craniovertebral junction [5,6]. The pathomechanism for pseudotumor formation has been postulated to the result of atlantoaxial instability that induces repeated tears and subsequent hypertrophy of the transverse ligaments [8,20]. Chikuda et al [10] found that retro-odontoid pseudotumor was not necessarily associated with overt atlantoaxial instability, but that excessive stress concentration to the atlantoaxial complex caused by altered biomechanics of the cervical spine due to OALL, OPLL and cervical kyphosis may cause repeated damage to the transverse ligament.…”

Section: Discussionmentioning

confidence: 99%

C1 laminectomy for retro-odontoid pseudotumor without atlantoaxial subluxation: review of seven consecutive cases

et al. 2013

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Purpose A retro-odontoid pseudotumor is usually a reactive fibrocartilaginous mass associated with atlantoaxial subluxation (AAS). However, a retro-odontoid pseudotumor not associated with AAS, which undergoes spontaneous regression following C1 laminoplasty, has been reported. The purpose of this study was to report surgical outcomes of C1 laminectomy for retro-odontoid pseudotumor without AAS. Materials and methods The cases of seven patients (mean age 75.6 ± 7.6 years-old) with retro-odontoid pseudotumor without AAS were reviewed. The mean follow up time was 52.3 ± 25.5 months. Each patient underwent a C1 laminectomy with an additional C3-6 expansion laminoplasty in three patients. The Japanese Orthopaedic Association score (JOA score) was used for neurological assessment. Pseudotumor size and additional AAS were analyzed using MRI and radiography. Results All patients exhibited neurological improvement following surgery, the JOA score improved from 7.2 ± 3.2 to 14.1 ± 2.6. The mean O-C2 and C2-7 angle decreased from -3.2 ± 2.1°to -3.9 ± 1.7°, showing a slight kyphotic change. Postoperative AAS was not observed. All pseudotumors spontaneously resolved, and recurrence and regrowth were not observed. Five patients had MRIs after gadolinium administration; four patients who showed enhancement of the pseudotumor had almost complete reduction within 1 year following surgery.Discussion Our study, assessing the outcome of C1 laminectomy for retro-odontoid pseudotumor, found neurological improvement in all cases. Since all pseudotumors were reduced and additional AAS was not observed, C1 laminectomy for retro-odontoid pseudotumor, in the absence of AAS, is recommended as a therapeutic strategy.

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Section: Discussionmentioning

confidence: 99%

C1 laminectomy for retro-odontoid pseudotumor without atlantoaxial subluxation: review of seven consecutive cases

et al. 2013

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“…1,5,6 Our patient had no history of trauma and no evidence of rheumatoid arthritis, but spondylotic changes were observed in the lower cervical spine, and slight instability at C1-C2 was seen. These findings suggest that the pathogenic mechanism described above may have been responsible for the development of the retro-odontoid mass in the present case.…”

Section: Discussionmentioning

confidence: 76%

“…3,13 However, in patients whose spinal cord impingement persists following reduction of the C1-C2 joint, C1 laminectomy and occipito-cervical posterior fusion has been the standard treatment procedure. 2,4,6,7 Both procedures bring about satisfactory neurological recovery and spontaneous repression of the post-odontoid mass. [2][3][4][5]7,8 However, biomechanical analyses have shown that the range of neck movement post-operatively is more restricted after posterior occipito-cervical fusion than after posterior C1-C2 fixation.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7] When spinal cord impingement by the retro-odontoid mass and the C1 posterior arch persists after reduction of the C1-C2 joint, most surgeons will select C1 laminectomy and occipito-cervical posterior fusion. 2,4,6,7 In most cases, myelopathy subsequently improves, together with spontaneous regression of the retro-odontoid mass, following this procedure. However, many patients experience a restricted range of neck movement after posterior occipito-cervical fusion.…”

Section: Introductionmentioning

confidence: 99%

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C1 dome-like laminotomy and posterior C1–C2 polyaxial screw-rod fixation for a patient with cervical myelopathy due to a retro-odontoid pseudotumor

Yamazaki

Okawa

Mannoji

et al. 2009

Journal of Clinical Neuroscience

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“…This type of O-C1 instability is occasionally accompanied with retro-odontoid pseudotumor (ROP) [1,4,6,15,17,18,24,…”

Section: Introductionmentioning

confidence: 99%

Exploration for reliable radiographic assessment method for hinge-like hypermobility at atlanto-occipital joint

et al. 2017

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Enlarging retro-odontoid pseudotumor after expanding cervical laminoplasty in the presence of kyphosis

Cited by 23 publications

References 11 publications

C1 laminectomy for retro-odontoid pseudotumor without atlantoaxial subluxation: review of seven consecutive cases

C1 laminectomy for retro-odontoid pseudotumor without atlantoaxial subluxation: review of seven consecutive cases

C1 dome-like laminotomy and posterior C1–C2 polyaxial screw-rod fixation for a patient with cervical myelopathy due to a retro-odontoid pseudotumor

Exploration for reliable radiographic assessment method for hinge-like hypermobility at atlanto-occipital joint

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