Retro-Odontoid Pseudotumor without Radiologic Atlantoaxial Instability: A Systematic Review

Robles, Luis A.; Mundis, Greg

doi:10.1016/j.wneu.2018.10.011

Cited by 27 publications

(25 citation statements)

References 41 publications

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“… 2 In most of the retro‐odontoid pseudotumor cases, the onset of symptoms involves progressive myelopathy, such as paralysis or paresthesia of extremities. 1 As far as we have examined, this is the first case report showing only dysesthesia of the occipital region without motor dysfunction after accidental trauma.…”

Section: Introductionmentioning

confidence: 70%

“…Retro‐odontoid pseudotumor is a condition wherein abnormal tissue formation is seen around the odontoid process, which causes cervicomedullary compression. 1 This condition has been increasingly diagnosed due to the more frequent use of magnetic resonance imaging (MRI) for the assessment of craniovertebral junction lesions. 2 In most of the retro‐odontoid pseudotumor cases, the onset of symptoms involves progressive myelopathy, such as paralysis or paresthesia of extremities.…”

Section: Introductionmentioning

confidence: 99%

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Retro‐odontoid pseudotumor with uncommon presentation of cervical spine injury

Kikuta

Ishihara

Yagata

et al. 2021

Acute Medicine & Surgery

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Background We report the first case of retro‐odontoid pseudotumor with an isolated symptom of C2–C3 dysesthesia triggered by a traumatic event. Case Presentation An 86‐year‐old man, who was a wood craftsman for more than 50 years, presented to the emergency room with sudden‐onset severe posterior head and neck dysesthesia after accidentally falling backward. No neurological impairment of the extremities was noted. Computed tomography revealed a C2–C7 osteophyte formation, mainly in front of the vertebral bodies. Moreover, magnetic resonance imaging showed cervical spinal cord compression by a soft tissue mass posterior to the odontoid process of the axis. Therefore, we diagnosed a cervical spine injury with an isolated symptom of C2–C3 dysesthesia due to a retro‐odontoid pseudotumor. He did not undergo surgical intervention and was transferred to a rehabilitation hospital on day 11 for pain control. Conclusion Our report could be useful to emergency physicians dealing with similar cases of cervical symptoms following trauma.

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Section: Introductionmentioning

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Retro‐odontoid pseudotumor with uncommon presentation of cervical spine injury

Kikuta

Ishihara

Yagata

et al. 2021

Acute Medicine & Surgery

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“…These results were compatible with published reports, in which AAD was not present in some cases of nonrheumatoid pseudotumors (Table 4). 26…”

Section: Clinical and Radiological Characteristicsmentioning

confidence: 99%

“…C1 lami-nectomy alone sometimes resulted in good neurological outcomes; 5,16,20 however, in some cases including our case 9, the pseudotumor did not regress. 26 Therefore, we propose that C1 laminectomy alone should be considered only for cases with a small pseudotumor.…”

Section: Surgery and Outcomesmentioning

confidence: 99%

Nonrheumatoid Retro-Odontoid Pseudotumors: Characteristics, Surgical Outcomes, and Time-Dependent Regression After Posterior Fixation

2021

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Objective: Although a retro-odontoid pseudotumor associated with rheumatoid arthritis is a well-known clinical entity, little is known about retro-odontoid pseudotumors not associated with rheumatoid arthritis due to their rarity. Methods: Between 2006 and 2019, consecutive patients with nonrheumatoid pseudotumors were included and retrospectively compared with patients with rheumatoid pseudotumors. Results: Nineteen patients had nonrheumatoid pseudotumors (mean age, 73 ± 6 years; male, 53%). All had cervical lesions including ossified anterior and posterior longitudinal ligaments with a history of cervical surgery in 5. The mean thickness of the pseudotumors at diagnosis was 8.1 mm (range, 4.2-17.2 mm). Pseudotumor thickness had a significant negative correlation with the atlantodental interval (p = 0.008) and the subaxial range of motion (p = 0.049). In comparison with 7 rheumatoid pseudotumor patients, nonrheumatoid pseudotumor patients were older (p = 0.042), had a higher proportion of males (p = 0.023), had a smaller atlantodental interval (p = 0.007), and had larger pseudotumors at diagnosis (p = 0.030). Of the 19 patients, 18 received posterior fixation with or without C1 laminectomy, while the other received C1 laminectomy alone. The percent pseudotumor thickness at follow-up to those at diagnosis was 91%, 77%, 68%, 46%, 58%, and 49% at 1, 3, 6, 12, 24, and 36 months after surgery, respectively. Conclusion: This study revealed markedly clinical and radiological differences between nonrheumatoid and rheumatoid pseudotumors. The main etiology for nonrheumatoid pseudotumors was subaxial cervical degeneration and ossified lesions. There were good outcomes following posterior fixation and time-dependent pseudotumor regression within 12 months.

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“…Retro-odontoid pseudotumor, or odontoid pannus, refers to a disease process characterized by non-neoplastic soft tissue proliferation that is adjacent to the odontoid process of cervical 2 (C2) vertebra, and can lead to compression of the vital neuronal structures of the cervicomedullary region. 1,2 LD. Anderson and RT.…”

Section: Introductionmentioning

confidence: 99%

Retro-Odontoid Pseudotumor Formation in the Context of Various Acquired and Congenital Pathologies of the Craniovertebral Junction and Surgical Techniques

et al. 2021

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Retro-odontoid pseudotumor formation consists of an abnormal growth of granulation tissue typically posterior to the odontoid process, resulting as a manifestation of atlantoaxial instability. This instability can occur as a result of conditions ranging from severe mechanical trauma to metabolic disease or autoimmune conditions such as rheumatoid arthritis. A pseudotumor may impinge on the spinal nerves or even the spinal cord and brainstem, manifesting symptoms from severe neck pain to cervicomedullary compression or myelopathy, and in some cases even sudden death. The objective of this review is to consolidate the findings in published case reports and relevant prior literature reviews regarding the formation of retro-odontoid pseudotumor. We address the pathophysiology involved in acquired and congenital pseudotumor formation, including those associated with rheumatoid arthritis (panni). Additionally, we discuss past and current operative techniques designed to curtail and ultimately regress a retro-odontoid pseudotumor and pannus. Surgical techniques that are addressed include ventral decompression (both transoral and transnasal), dorsal decompression, and indications for posterior instrumentation in pannus formation, particularly in cases that may be sufficiently treated in lieu of an anterior approach. Finally, we will examine the role of external orthoses as both a method of conservative treatment as well as a potential adjunct to the aforementioned surgical procedures.

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Retro-Odontoid Pseudotumor without Radiologic Atlantoaxial Instability: A Systematic Review

Cited by 27 publications

References 41 publications

Retro‐odontoid pseudotumor with uncommon presentation of cervical spine injury

Retro‐odontoid pseudotumor with uncommon presentation of cervical spine injury

Nonrheumatoid Retro-Odontoid Pseudotumors: Characteristics, Surgical Outcomes, and Time-Dependent Regression After Posterior Fixation

Retro-Odontoid Pseudotumor Formation in the Context of Various Acquired and Congenital Pathologies of the Craniovertebral Junction and Surgical Techniques

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