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Updated: Jun 25, 2025

Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review
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Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review

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Circumferential Pannus at C1-C2 Causing Spinal Cord Compression.

Luis A Robles1, Sulaman Durrani1, Ian Côté1

  • 1Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.

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|May 30, 2024
PubMed
Summary
This summary is machine-generated.

Periodontoid pannus, often from rheumatoid arthritis, can compress the spinal cord. This case uniquely shows circumferential C1-C2 pannus causing severe myelopathy, successfully treated with surgery.

Keywords:
Craniocervical stenosisRetro-odontoid pannusRetro-odontoid pseudotumor

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Area of Science:

  • Spine Surgery
  • Rheumatology
  • Neurology

Background:

  • Periodontoid pannus, commonly linked to rheumatoid arthritis, typically forms in the retro-odontoid space.
  • This condition can lead to progressive neural compression and cervical myelopathy.
  • The pannus is usually situated ventral to the spinal cord.

Observation:

  • A patient presented with progressive high cervical myelopathy.
  • Imaging revealed both a retro-odontoid pannus and a posterior C1-C2 mass.
  • This combination caused severe, circumferential spinal cord compression at the C1-C2 level.

Findings:

  • The patient's C1-C2 posterior pannus was a unique finding, distinct from typical retro-odontoid pannus.
  • Circumferential pannus at C1-C2 causing neural compression has not been previously reported.
  • Surgical intervention, including C1-C2 laminectomy and occipitocervical fusion, successfully treated the patient.

Implications:

  • This case expands the understanding of periodontoid pannus presentation and location.
  • It highlights the potential for posterior C1-C2 pannus to cause severe myelopathy.
  • The successful surgical outcome suggests a viable treatment option for this rare condition.