Department of Neurosurgery, Division of Neuroscience, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641, Japan.
J Clin Neurosci. 2010 May;17(5):649-52. doi: 10.1016/j.jocn.2009.07.116. Epub 2010 Feb 26.
A retro-odontoid pseudotumor (ROP) is commonly associated with atlantoaxial subluxation (AAS). Here, we report a patient with ROP but without AAS. The patient was a 72-year-old man who did not have a history of rheumatoid arthritis or trauma to the head and neck. The patient was admitted to our hospital with gait disturbance, progressive motor weakness in both upper extremities and sensory disturbance in all four extremities. MRI showed a retro-odontoid mass with severe compression of the cervical spinal cord. A CT scan showed spondylotic changes in C5, C6, and C7 and bilateral facet fusion between C3 and C4. Dynamic radiography showed no evidence of AAS; there was loss of mobility at C2-C7 and excessive mobility at C1. Intraoperative pathological examination revealed that the lesion was a pseudotumor; therefore, posterior C1-C2 fixation was performed. MRI performed 6 months after the operation revealed that the pseudotumor was markedly reduced. To the best of our knowledge, patients with ROP without AAS are uncommon.
齿状突后假瘤（ROP）通常与寰枢关节半脱位（AAS）有关。在此，我们报告一例无 AAS 的 ROP 患者。患者为 72 岁男性，无类风湿关节炎病史，也无头部和颈部外伤史。该患者因步态障碍、四肢进行性上运动神经元无力和感觉障碍而入院。MRI 显示齿状突后有肿块，严重压迫颈脊髓。CT 扫描显示 C5、C6 和 C7 有骨关节炎改变，C3 和 C4 双侧小关节融合。动态 X 线摄影显示无 AAS 证据；C2-C7 活动度丧失，C1 活动度过度。术中病理检查显示病变为假瘤，因此行 C1-C2 后路固定术。术后 6 个月行 MRI 检查显示假瘤明显缩小。据我们所知，无 AAS 的 ROP 患者并不常见。
