Yamaguchi Ikuko, Shibuya Sei, Arima Nobuo, Oka Shiro, Kanda Yoshiaki, Yamamoto Tetsuji
Department of Orthopaedic Surgery, Kagawa University School of Medicine, Kagawa, Japan.
J Neurosurg Spine. 2006 Aug;5(2):156-60. doi: 10.3171/spi.2006.5.2.156.
Retroodontoid or periodontoid pseudotumor unassociated with rheumatoid arthritis or hemodialysis is clinically rare. The authors report three cases of retroodontoid pseudotumor that they treated surgically. All patients exhibited myelopathy of the upper cervical spinal cord. Plain radiography depicted atlantoaxial instability in two of the three patients. Spinal cord compression caused by a mass lesion in all patients was clearly demonstrated on magnetic resonance images. In two patients, the mass lesion was not limited to the retroodontoid region and expanded continuously to the cranial base. Posterior laminectomy of the atlas and occipitocervical fusion were performed. After surgery, the pseudotumor disappeared in two cases and was clearly reduced in one case, and neurological symptoms also improved. Retroodontoid pseudotumor is a lesion for which symptomatic improvement can be expected with posterior decompression and fusion, even without direct tumor excision.
与类风湿性关节炎或血液透析无关的齿突后或齿周假性肿瘤临床上较为罕见。作者报告了他们手术治疗的3例齿突后假性肿瘤病例。所有患者均表现为上颈段脊髓病。普通X线摄影显示3例患者中有2例存在寰枢椎不稳。磁共振成像清楚地显示了所有患者均存在由肿块病变引起的脊髓受压。在2例患者中，肿块病变不仅局限于齿突后区域，还持续扩展至颅底。实施了寰椎后椎板切除术和枕颈融合术。术后，2例患者的假性肿瘤消失，1例明显缩小，神经症状也有所改善。齿突后假性肿瘤即使不直接切除肿瘤，通过后路减压和融合也有望实现症状改善。
