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Retrodental fibrocartilaginous mass. Report of a case
Study Design:
This is a report of a 63-year-old woman with a retrodental fibrocartilaginous mass and myelopathy.
Objective:
To describe the pathophysiology of the retrodental fibrocartilaginous mass formation and its association with the C2-C3 disc.
Summary Of Background Data:
High cervical disc protrusion is an uncommon condition and presents even more rarely as a craniovertebral junction mass with spinal cord compression. Uncertainty remains regarding the etiology of its formation in the retrodental region.
Methods:
The patient underwent surgical intervention with transoral decompression and posterior C1-C2 skeletal fusion with bony graft.
Results:
On the basis of dynamic plain radiographs, magnetic resonance imaging, and surgical pathology, the origin of the mass may have been the C2-C3 disc.
Conclusions:
We hypothesized that the mechanism underlying the posterior odontoid fibrocartilaginous mass with spinal cord involvement most likely originate upward migration of the C2-C3 annulus fragment to the atlantoaxial joint as a result of aging. Secondary fibrocartilaginous metaplasia plays a major role in creating such disc-like material. To prevent unrecoverable myelopathy, early detection and anterior decompression with posterior C1-C2 skeletal fixation and bony fusion are the best treatment methods.