title: Pannus resolution after occipitocervical fusion in a non-rheumatoid atlanto-axial instability.
abstract: Periodontoid pseudotumor or pannus is considered to be an inflammatory mass most frequently associated with rheumatoid arthritis. Transoral resection of the pannus has been the treatment of choice for patients with associated myelopathy, followed in many instances by posterior stabilization. However, some authors have reported resolution of pannus associated with rheumatoid arthritis and other forms of chronic atlanto-axial instability only after posterior stabilization. We report a case of a 69-year-old man who presented with a rapidly progressing myelopathy due to a retro-odontoid mass produced by chronic atlanto-axial instability associated with an occipital assimilation of C1 and tight posterior fossa. An urgent posterior fossa craniectomy followed by occipitocervical fixation was performed. After surgery, the patient's clinical condition improved and 1 year after surgery was asymptomatic, walked without any help and had normal strength. Control MR showed complete resolution of the retro-odontoid pannus.
authors.affiliation: Department of Neurosurgery, Hospital 12 de Octubre, Madrid, Spain. algadoc@yahoo.com
authors.forename: Alfonso
authors.initials: A
authors.lastname: Lagares
authors.forename: Iñaki
authors.initials: I
authors.lastname: Arrese
authors.forename: Beatriz
authors.initials: B
authors.lastname: Pascual
authors.forename: Pedro A
authors.initials: PA
authors.lastname: Gòmez
authors.forename: Ana
authors.initials: A
authors.lastname: Ramos
authors.forename: Ramiro D
authors.initials: RD
authors.lastname: Lobato
mesh_terms: D000368:Aged; D001268:Atlanto-Axial Joint / Q000002:abnormalities* / Q000601:surgery; D002574:Cervical Vertebrae / Q000601:surgery*; D006104:Granuloma, Plasma Cell / Q000601:surgery*; D006801:Humans; D007593:Joint Instability / Q000601:surgery; D008297:Male; D009777:Occipital Bone / Q000601:surgery*; D013118:Spinal Cord Diseases / Q000209:etiology; D013123:Spinal Fusion; D016896:Treatment Outcome