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Retro-odontoid cystic mass treated by laminectomy and C1-C2 fixation.

Lin D, Ding Z, Guo Y, Lian K - Indian J Orthop (2014)

Bottom Line: Retro-odontoid cysts associated with chronic atlantoaxial subluxation are extremely rare.A 64-year-old woman experienced a sudden onset of neck pain, hand and foot paresthesia.Atlantoaxial instability associated with a retro-odontoid cystic mass was found in the imaging.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, The Affiliated Southeast Hospital of Xiamen University, Orthopaedic Center of People's Liberation Army, Zhangzhou 363000, China.

ABSTRACT
Retro-odontoid cysts associated with chronic atlantoaxial subluxation are extremely rare. This article describes a case of retro-odontoid cystic mass associated with chronic atlantoaxial subluxation and its management with posterior C1 and partial C2 laminectomy and C1-C2 pedicle screw fixation without resection of the retro-odontoid cyst. A 64-year-old woman experienced a sudden onset of neck pain, hand and foot paresthesia. Atlantoaxial instability associated with a retro-odontoid cystic mass was found in the imaging. The patient underwent posterior C1 and partial C2 laminectomy and C1-C2 pedicle screws fixation without resection of the retro-odontoid cyst. During the 24 months followup period, the cyst disappeared completely and the patient remained symptom free and returned to independent daily living. These findings suggest that posterior laminectomy and fixation without resection of the retro-odontoid cyst is relatively simple and safe and the results are satisfactory.

No MeSH data available.


Related in: MedlinePlus

(a-c) Preoperative open-mouth anteroposterior radiograph and dynamic flexion and extension radiograph showing the atlantoaxial instability. (d and e) Preoperative computed tomography revealed an abnormality of the odontoid process. (f) The mass showed uniform low intensity on T1-weighted image. (g) The mass showed uniform high signal intensity on T2-weighted image
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Figure 1: (a-c) Preoperative open-mouth anteroposterior radiograph and dynamic flexion and extension radiograph showing the atlantoaxial instability. (d and e) Preoperative computed tomography revealed an abnormality of the odontoid process. (f) The mass showed uniform low intensity on T1-weighted image. (g) The mass showed uniform high signal intensity on T2-weighted image

Mentions: A 64 year old woman reported experiencing a sudden onset of neck pain, hand and foot paresthesia when she woke early in the morning. She was sent to a local hospital, where she was treated conservatively with external stabilization of the neck and bed rest. At 2 weeks later, the patient was transferred to our hospital because her symptoms had not relieved. There were no clinical or laboratory findings of rheumatoid arthritis. There was no history of head and neck trauma. X-ray showed that the atlantoaxial instability [Figure 1a-c]. Computed tomography revealed an abnormality of the odontoid process [Figure 1d and e]. Magnetic resonance imaging detected an oval retro-odontoid cystic mass, which compressed the spinal cord. The mass showed uniform low intensity on T1-weighted image [Figure 1f] and uniform high signal intensity on T2-weighted image [Figure 1g].


Retro-odontoid cystic mass treated by laminectomy and C1-C2 fixation.

Lin D, Ding Z, Guo Y, Lian K - Indian J Orthop (2014)

(a-c) Preoperative open-mouth anteroposterior radiograph and dynamic flexion and extension radiograph showing the atlantoaxial instability. (d and e) Preoperative computed tomography revealed an abnormality of the odontoid process. (f) The mass showed uniform low intensity on T1-weighted image. (g) The mass showed uniform high signal intensity on T2-weighted image
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4232834&req=5

Figure 1: (a-c) Preoperative open-mouth anteroposterior radiograph and dynamic flexion and extension radiograph showing the atlantoaxial instability. (d and e) Preoperative computed tomography revealed an abnormality of the odontoid process. (f) The mass showed uniform low intensity on T1-weighted image. (g) The mass showed uniform high signal intensity on T2-weighted image
Mentions: A 64 year old woman reported experiencing a sudden onset of neck pain, hand and foot paresthesia when she woke early in the morning. She was sent to a local hospital, where she was treated conservatively with external stabilization of the neck and bed rest. At 2 weeks later, the patient was transferred to our hospital because her symptoms had not relieved. There were no clinical or laboratory findings of rheumatoid arthritis. There was no history of head and neck trauma. X-ray showed that the atlantoaxial instability [Figure 1a-c]. Computed tomography revealed an abnormality of the odontoid process [Figure 1d and e]. Magnetic resonance imaging detected an oval retro-odontoid cystic mass, which compressed the spinal cord. The mass showed uniform low intensity on T1-weighted image [Figure 1f] and uniform high signal intensity on T2-weighted image [Figure 1g].

Bottom Line: Retro-odontoid cysts associated with chronic atlantoaxial subluxation are extremely rare.A 64-year-old woman experienced a sudden onset of neck pain, hand and foot paresthesia.Atlantoaxial instability associated with a retro-odontoid cystic mass was found in the imaging.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, The Affiliated Southeast Hospital of Xiamen University, Orthopaedic Center of People's Liberation Army, Zhangzhou 363000, China.

ABSTRACT
Retro-odontoid cysts associated with chronic atlantoaxial subluxation are extremely rare. This article describes a case of retro-odontoid cystic mass associated with chronic atlantoaxial subluxation and its management with posterior C1 and partial C2 laminectomy and C1-C2 pedicle screw fixation without resection of the retro-odontoid cyst. A 64-year-old woman experienced a sudden onset of neck pain, hand and foot paresthesia. Atlantoaxial instability associated with a retro-odontoid cystic mass was found in the imaging. The patient underwent posterior C1 and partial C2 laminectomy and C1-C2 pedicle screws fixation without resection of the retro-odontoid cyst. During the 24 months followup period, the cyst disappeared completely and the patient remained symptom free and returned to independent daily living. These findings suggest that posterior laminectomy and fixation without resection of the retro-odontoid cyst is relatively simple and safe and the results are satisfactory.

No MeSH data available.


Related in: MedlinePlus