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[Retro-odontoid pseudotumor in diffuse idiopathic skeletal hyperostosis]
Julián Castro-Castro1, Daniel Castro-Bouzas1, Alfonso Pinzón-Millán1
1Servicio de Neurocirugía, Complexo Hospitalario Universitario de Ourense, Ourense, España.
Neurocirugia (Asturias, Spain)
|March 8, 2013
Summary
Retro-odontoid pseudotumors, often linked to atlantoaxial instability, can cause severe myelopathy. Surgical intervention in a diffuse idiopathic skeletal hyperostosis patient successfully reduced the pseudotumor and improved neurological function.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Radiology
Background:
- Retro-odontoid pseudotumors are typically associated with chronic atlantoaxial instability.
- A significant portion of reported cases lack clear evidence of atlantoaxial instability.
- Diffuse idiopathic skeletal hyperostosis can present with spinal cord compression.
Observation:
- A 76-year-old male with diffuse idiopathic skeletal hyperostosis presented with progressive myelopathy.
- Cervical spine MRI revealed a retro-odontoid predural mass causing severe spinal cord compression.
- The patient had no clear signs of atlantoaxial instability.
Findings:
- Surgical decompression via posterior laminectomy of the atlas and occipitocervical fusion was performed.
- Post-operatively, the retro-odontoid pseudotumor significantly decreased in size.
- The patient experienced substantial improvement in neurological symptoms.
Implications:
- This case highlights that retro-odontoid pseudotumors can occur without overt atlantoaxial instability.
- Surgical management can be effective in decompressing the spinal cord and improving outcomes.
- Further research may be needed to understand the etiology of pseudotumors in the absence of instability.
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