Immediate Postoperative Disappearance of Retro-Odontoid "Pseudotumor"
Immediate Postoperative Disappearance of Retro-Odontoid "Pseudotumor"
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DOI：
10.1016/j.wneu.2016.04.050
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发表时间：
2016-07-01
影响因子：
2
通讯作者：
Goel, Atul
中科院分区：
文献类型：
--
作者：
Shah, Abhidha;Jain, Sonal;Goel, Atul
目的：作者报告了2例明显的寰枢椎不稳和齿状突后假瘤。齿状突后肿瘤在手术后即刻消失，手术涉及关节面牵引和寰枢椎固定。对案件进行了讨论。虽然回归后齿状突假瘤已报告寰枢椎固定后，其消失在术后即刻阶段还没有recorded.METHODS：两名患者（42岁和16岁）进行性四肢轻瘫。检查发现齿状突后“假瘤”和脊髓压迫的证据。两例病例均存在寰枢椎不稳的影像学证据。2例患者均采用寰枢椎外侧小关节牵引固定。结果：患者术后临床症状明显改善。术后即刻影像学检查显示假性肿瘤消失。结论：齿状突后假性肿瘤似乎与后纵韧带屈曲有关。小关节面的牵张可能有助于后纵韧带的伸展。我们的经验再次证实齿状突后假性肿瘤可能是寰枢椎不稳的一种表现，不需要直接手术治疗。
OBJECTIVE: The authors present reports of 2 cases in which there was manifest atlantoaxial instability and presence of retro-odontoid pseudotumor. The retro-odontoid tumor disappeared in the immediate postoperative phase after surgery, which involved facetal distraction and atlantoaxial fixation. The cases are discussed. Although regression of the retro-odontoid pseudotumor has been reported after atlantoaxial fixation, its disappearance in the immediate postoperative phase has not been recorded.METHODS: Two patients (42 years and 16 years old) presented with progressive quadriparesis. Investigations revealed presence of retro-odontoid "pseudotumor" and evidence of cord compression. There was radiologic evidence of atlantoaxial instability in both cases. Both patients were treated by atlantoaxial lateral facet distraction and fixation. No attempt was made to directly manipulate or handle the retro-odontoid tissue.RESULTS: The patients had remarkable clinical improvement after surgery. Immediate postoperative imaging showed disappearance of pseudotumor.CONCLUSIONS: The retro-odontoid pseudotumor appears to be related to buckling of the posterior longitudinal ligament. Distraction of the facets probably assists in stretching of the posterior longitudinal ligament. Our experience reconfirms that retro-odontoid pseudotumor could be a manifestation of atlantoaxial instability and need not be directly handled by surgery.