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Exuberant transverse ligament degeneration causing high cervical myelopathy
C Y Cai1, C A Palmer, C G Paramore
1Department of Surgery, the University of Alabama at Birmingham, USA.
Journal of Spinal Disorders
|March 10, 2001
Summary
Degenerative transverse ligament changes can cause C1-C2 retro-odontoid masses and cervical myelopathy. Pathologic examination revealed fibrocartilage, not rheumatoid arthritis, suggesting a unified disease process.
Area of Science:
- Orthopedics
- Neurology
- Pathology
Background:
- Cervical myelopathy can result from C1-C2 retro-odontoid masses.
- Preoperative imaging may suggest soft tissue pannus, mimicking rheumatoid arthritis.
Observation:
- Two patients with cervical myelopathy and C1-C2 retro-odontoid masses were evaluated.
- Serologic testing for rheumatoid factor was negative in both cases.
Findings:
- Intraoperative and pathologic findings revealed degenerative fibrocartilage without inflammation or neoplasia.
- These masses represent exuberant degeneration of the transverse ligament.
Implications:
- Retro-odontoid masses may share a common origin: transverse ligament degeneration.
- This finding potentially unifies various described retro-odontoid lesions under a single pathophysiologic process.