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[老年患者齿突后肿物且无寰枢椎半脱位:病例报告]

[Retroodontoid mass without atlantoaxial subluxation in an elderly patient: case report].

作者信息

Morofuji Yoichi, Asami Naoki, Ishizaka Hiroaki

机构信息

Ishizaka Neurosurgical Hospital.

出版信息

No Shinkei Geka. 2007 Jan;35(1):79-83.

Abstract

A Mass at the craniovertebral junction is relatively rare. We report a case of retroodontoid mass without atlantoaxial subluxation. An 84-year-old female presented to our hospital with paresthesia in the right upper and lower limb. She had no history of head or spine injury. Neurological examination revealed slight motor weakness of the right upper and lower limb. Cervical radiographs showed osteoarthrosis without atlantoaxial subluxation. MRI revealed retroodontoid, extra-dural mass that severely compressed the adjacent spinal cord. The patient underwent C1 laminectomy and posterior C1-C2 fusion with polyaxial screw and rod fixation. Simultaneously, the mass was resected partially. Histopathologically, the surgical specimen was a non-neoplastic fibrocartliginous mass and inflammatory cells were not seen. Postoperative course was uneventful and her neurological condition gradually improved. MRI revealed marked reduction of the mass and improvement of the spinal cord compression six months after the operation. We discuss the genesis of the retroodontoid mass and the strategy for surgical treatment.

摘要

颅颈交界区肿物相对少见。我们报告一例齿突后方肿物且无寰枢椎半脱位的病例。一名84岁女性因右上肢和下肢感觉异常来我院就诊。她无头部或脊柱损伤史。神经系统检查发现右上肢和下肢轻度运动无力。颈椎X线片显示骨关节炎但无寰枢椎半脱位。磁共振成像(MRI)显示齿突后方硬膜外肿物,严重压迫相邻脊髓。患者接受了C1椎板切除术及后路C1-C2融合术并采用多轴螺钉和棒固定。同时,部分切除肿物。组织病理学检查显示手术标本为非肿瘤性纤维软骨肿物,未见炎性细胞。术后过程顺利,其神经状况逐渐改善。术后6个月MRI显示肿物明显缩小,脊髓压迫改善。我们讨论了齿突后方肿物的发生机制及手术治疗策略。

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