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  • Title: Retro-odontoid pseudotumor concomitant with proximal adjacent cervical spondylotic myelopathy after multilevel anterior cervical discectomy and fusion.
    Author: Liawrungrueang W, Tantivorawit W, Sugandhavesa N, Bunmaprasert T.
    Journal: Int J Surg Case Rep; 2021 Sep; 86():106352. PubMed ID: 34455295.
    Abstract:
    INTRODUCTION AND IMPORTANCE: Adjacent cervical spondylotic myelopathy (CSM) following anterior cervical discectomy and fusion (ACDF) presenting as a retro-odontoid pseudotumor (ROP) is uncommon. This consequence adversely affects hand function, causes gait imbalance and results in other disabilities for the patient. This report describes the successful surgical treatment of a patient with ROP associated with adjacent CSM following multilevel ACDF of the subaxial cervical vertebrae by performing posterior cervical decompression and fusion. CASE PRESENTATION: A 60-year-old-male presented with progressive, disabling cervical myelopathy. He had undergone ACDF C3-C7 for treatment of CSM 16 years ago and his symptoms had fully resolved. Magnetic resonance imaging (MRI) revealed severe cervical spinal cord compression caused by a retro-odontoid mass at the C1-C2 level with upper adjacent segment disease (ASD) of C1-C3. The patient received C1-C3 posterior cervical spinal fusion by C1 lateral mass C2 and C3 pedicle screw fixation and C1-C3 laminectomy. After the surgery, he was able to ambulate independently and the myelopathic symptoms were significantly improved at the 6 months follow-up. CLINICAL DISCUSSION: Retro-odontoid pseudotumor concomitant with proximal ASD following ACDF is a rare occurrence. Both diagnosis and surgical management are challenging. CONCLUSIONS: Posterior cervical decompression and fusion of C1-C3 is an effective option for treatment of severe cervical spinal cord compression by a retro-odontoid mass at the C1-C2 level combined with ASD after ACDF.
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