軸椎歯突起後方偽腫瘍に対し環椎後弓切除を施行した2症例

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  • Two Cases of Retroodontoid Pseudotumor Treated with Laminectomy of the Atlas

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We report two cases of laminectomy of the atlas for retroodontoid pseudotumor. Case 1 was a 92-year-old man with a one-year history of progressive numbness and clumsy bilateral upper extremities. Plain radiograph showed spondylosis of the atlanto-axial joint in the cervical spine, and subluxation of the atlas was not associated. Magnetic resonance image (MRI) revealed an extradural mass with iso signal intensity on T1 weighted image and low on T2 weighted image behind the odontoid, compressing the spinal cord at the level of the atlas. We performed laminectomy of the atlas. Three years and five months after the surgery, symptoms obviously improved. Case 2 was an 81-year-old man presented with a three-month history of spastic gait and bilateral clumsy hands. He had severe chronic heart failure. Plain radiograph showed slight subluxation of the atlanto-axial joints. MRI revealed an extradural mass behind the odontoid, strongly compressing the spinal cord at the level of atlas.We performed laminectomy of the atlas, and symptoms obviously improved. Thus, we recommend laminectoy of the atlas as an effective treatment for retroodontoid pseudotumor, especially for elder patients with severe complications.

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