title: Recurrent atlantoaxial synovial cyst resection via a navigation-guided, endoscope-assisted posterior approach.
abstract: BACKGROUND
  Atlantoaxial cysts are rare, and only 46 histologically confirmed cases have been reported.
  
  
  METHODS
  A 75-year-old male presented 2 years ago with headache, neck pain, loss of balance, and episodic dysphagia, for which he had undergone posterior cervical drainage of a left-sided atlantoaxial cyst. Although his original symptoms resolved, they recurred 2 years later and were correlated with an enhanced MR that showed a recurrent left C1-C2 synovial cyst causing marked cervical cord compression. It was successfully resected through a navigation-guided, endoscope-assisted posterior approach. The patient's symptoms/signs resolved completely, and he has remained symptom-free for over 30 months postoperatively, with no evidence of recurrence on MR or craniocervical instability.
  
  
  CONCLUSIONS
  A patient who successfully underwent resection of a recurrent synovial cervical cyst using a navigation-guided, endoscope-assisted posterior approach has been reported here.
authors.affiliation: Department of Neurological Surgery, Wexner Medical Center, The Ohio State University, Columbus, Ohio, USA ; Department of Neurosurgery, Umberto I General Hospital, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Colasanti
authors.affiliation: Department of Neurological Surgery, Wexner Medical Center, The Ohio State University, Columbus, Ohio, USA.
authors.forename: Tariq
authors.initials: T
authors.lastname: Lamki
authors.affiliation: Department of Neurological Surgery, Wexner Medical Center, The Ohio State University, Columbus, Ohio, USA.
authors.forename: Al-Rahim A
authors.initials: AR
authors.lastname: Tailor
authors.affiliation: Department of Neurological Surgery, Wexner Medical Center, The Ohio State University, Columbus, Ohio, USA.
authors.forename: Mario
authors.initials: M
authors.lastname: Ammirati
keywords: Atlantoaxial joint; endoscopic assistance; intraoperative navigation; posterior approach; semi-sitting position; synovial cyst