Microsurgical Excision of a Retro-odontoid Disc Hernia via a Far-lateral Approach: Successful Treatment of a Rare Cause of Myelopathy: Case Report

Abstract

Sagittal, T1-weighted, magnetic resonance imaging scans demonstrated a low-intensity band between the odontoid process and the body of the axis, which suggested a persistent cartilaginous band. Although upward migration of a herniated disc from the lower cervical spine and degeneration of retro-odontoid ligaments might be possible causes, a persistent cartilaginous band extending between the odontoid process and the body of the axis was considered to be the more likely origin of the retro-odontoid intervertebral disc hernia. Because the far-lateral surgical approach does not require retraction of the cervical cord and provides safe access to the lesion at the craniovertebral junction, it is a suitable surgical method for this condition.

Posterior C1-2 Fixation With Cancellous Screw and Rod System for Retro-odontoid Pseudotumor Associated With Chronic Atlantoaxial Subluxation-Technical Note-

“…1,2,16,18,23,25,26) The etiology of the pseudotumor remains controversial. Treatment strategies include lesion resection or C1-2 fixation, or a combination of these procedures.…”

Retro-odontoid pseudotumor without atlantoaxial subluxation

“…Surgical removal of the retro-odontoid mass is recommended for type 3 ROP. 12,14 Here, we have reported a patient with a rare ROP without AAS. To prevent the progression of ROP, we performed surgery to relieve the mechanical stress at the atlantoaxial junction.…”

“…This ROP is caused by a herniated disc between C2 and C3 that penetrates the posterior longitudinal ligament and migrates upward to the retro-odontoid space. 12,14 The disc hernia is probably related to mid cervical and lower cervical spondylosis. 12 Because of the presence of the herniated tissue, type 3 ROP would appear as a low intensity or an isointense area on T1-weighted MRI and a low intensity area on T2-weighted MRI.…”

A modified “far-lateral” approach for safe resection of retroodontoid dural cysts

“…They may be associated with trauma, instability or rheumatoid arthritis. Differential diagnosis includes tumors such as meningiomas or metastasis [7], rheumatoid arthritis or atypically enlarged vessels [10]. The natural course of these lesions is unknown.…”