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J Spinal Disord Tech. 2009 Feb;22(1):58-61. doi: 10.1097/BSD.0b013e31815e6d3c.

Resolution of intraspinal retro-odontoid cyst associated with os odontoideum after posterior fixation.

Author information

  • 1Department of Orthopaedic Surgery, Ehime University School of Medicine, Tohon-city, Ehime, Japan. ogata@m.ehime-u.ac.jp

Abstract

STUDY DESIGN:

A case report and review of previous literature.

OBJECTIVES:

To describe the diagnosis and successful treatment of an intraspinal retro-odontoid cyst associated with an os odontoideum.

SUMMARY OF BACKGROUND DATA:

Retro-odontoid cysts associated with atlantoaxial instability are extremely rare. Direct excision of the cysts has commonly been performed for the surgical treatment of myelopathy.

METHODS:

A retro-odontoid cyst in a 58-year-old woman with os odontoideum was treated surgically by posterior fixation between C1 and C3 without resection of the retro-odontoid mass. The patient's history, clinical examination, imaging findings, and treatment are reported.

RESULTS:

The patient experienced walking difficulty, numbness in the upper and lower limbs, and hypesthesia in both hands. Congenital C2/3 fusion and atlantoaxial instability associated with an os odontoideum were found in the radiographs. Magnetic resonance imaging detected a round retro-odontoid mass, which compressed the spinal cord. The mass showed uniform low intensity on T1-weighted images and uniform high signal intensity on T2-weighted images. Gadolinium-diethylenetriaminepenta-acetic acid-enhanced T1-weighted images showed rim enhancement of the mass with no internal enhancement. Three months after the operation, the mass was no longer visible in a magnetic resonance imaging examination and the patient completely recovered motor function in her extremities.

CONCLUSIONS:

Posterior fixation without resection was successfully used to eliminate a retro-odontoid cyst associated with atlantoaxial instability.

PMID:
19190437
[PubMed - indexed for MEDLINE]
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