Retro-odontoid soft tissue mass associated with atlantoaxial subluxation in an elderly patient: A case report
Retro-odontoid soft tissue mass associated with atlantoaxial subluxation in an elderly patient: A case report
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DOI：
10.1016/s0090-3019(01)00345-7
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发表时间：
2001-04-01
影响因子：
--
通讯作者：
Kobayashi, H
中科院分区：
文献类型：
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作者：
Isono, M;Ishii, K;Kobayashi, H
背景：我们报告了一例老年患者的后齿状软组织肿块与寰枢半脱位相关。病例描述一名74岁男性因右臂进行性运动无力和颈部疼痛入住我院。影像学检查显示寰枢椎半脱位和弥漫性退行性改变。颈椎MRI显示C1水平有鸣管，齿状突后软组织肿块严重压迫脊髓。肿块在T1和t2加权图像上均呈低信号。保守治疗无法阻止患者症状的恶化，因此我们通过C1椎板切除术和枕颈固定进行后路减压。这些手术改善了他的神经系统状况，减轻了脊髓的重量和压迫。结论该患者无任何可能导致慢性寰枢关节半脱位的特殊情况。退行性改变本身可能引起慢性寰枢椎半脱位和随后的齿状突后软组织肿块。对于这种情况的患者，不直接切除肿块的后路固定应是手术干预的首选。(C) 2001年Elsevier Science Inc.
BACKGROUNDWe present the case of an elderly patient with a retro-odontoid soft tissue mass associated with atlanto-axial subluxation.CASE DESCRIPTIONA 74-year-old man was admitted to our hospital with progressive motor weakness in his right arm and neck pain. Radiological examinations revealed atlantoaxial subluxation and diffuse degenerative changes. Cervical MRI revealed a syrinx at the C1 level and a retro-odontoid soft tissue mass that severely compressed the spinal cord. The mass was of low signal intensity on both T1 and T2-weighted images. Conservative therapy could not stop the progression of his symptoms, so posterior decompression via a laminectomy of C1 and occipitocervical fixation was performed. These procedures resulted in an improvement of his neurological condition and in reduction of the mass and the compression of the spinal cord.CONCLUSIONThe patient lacked any specific conditions that might have caused chronic atlantoaxial subluxation. The degenerative changes alone might have provoked chronic atlantoaxial subluxation and a subsequent retro-odontoid soft tissue mass. In patients with this condition, posterior fixation without direct removal of the mass should be the first choice for surgical intervention. (C) 2001 by Elsevier Science Inc.