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Periodontoid pseudotumoral lesions
Andrew Vinícius de Souza Batista1, Guilherme Brasileiro de Aguiar1, Priscilla Bennett1
1Department of Surgery, Santa Casa de Sao Paulo School of Medical Sciences, São Paulo, Brazil.
Surgical Neurology International
|September 13, 2021
Summary
Periodontoid pseudotumoral lesions (PPL) are rare causes of neck pain and myelopathy. Management varies from conservative (orthosis) to surgical (arthrodesis) based on atlantoaxial instability (AAI) presence, with good outcomes reported.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Radiology
Background:
- Periodontoid pseudotumoral lesions (PPL) are uncommon spinal tumors causing cervical pain and myelopathy.
- These lesions can be associated with atlantoaxial instability (AAI).
Observation:
- Two elderly patients presented with isolated neck pain and MRI-revealing expansive lesions of the odontoid process.
- One patient with AAI underwent occipitocervical arthrodesis; the other, without instability, was managed with a Philadelphia collar.
Findings:
- Both patients achieved complete pain resolution and remained neurologically intact at an average 36-month follow-up.
- This highlights successful outcomes with tailored management strategies.
Implications:
- Discusses clinical presentation, MRI characteristics, and management options for PPL.
- Differentiates surgical versus non-surgical approaches based on the presence or absence of AAI.
- Emphasizes the importance of accurate diagnosis and individualized treatment for PPL.
