title: Posterior C1-C2 calcium pyrophosphate dihydrate crystal deposition disease.
abstract: Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease rarely occurs in the posterior aspect of the craniocervical junction (CCJ). To the best of our knowledge, there have been only 2 previously reported cases of patients with posterior CPPD lesions in this region that have led to cervical myelopathy. We report the case of a 70-year-old man presenting with neck pain and cervical myelopathy with multilevel stenosis from C1-C6. The stenosis was worst at C1-C2, secondary to compression by a CPPD lesion posterior to the spinal cord. The patient underwent a C2-C6 laminectomy and fusion with resection of the CPPD lesion. In this report, we discuss the patient and present a novel theory to explain the preponderance of CPPD lesions in the CCJ occurring anteriorly and not posteriorly to the spinal cord.
authors.affiliation: Department of Neurosurgery, Tufts Medical Center and Tufts University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Isaac Bing-Yi
authors.initials: IB
authors.lastname: Ng
authors.affiliation: Department of Pathology, Tufts Medical Center, Boston, Massachusetts, USA.
authors.forename: Knarik
authors.initials: K
authors.lastname: Arkun
authors.affiliation: Department of Neurosurgery, Tufts Medical Center and Tufts University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Ron I
authors.initials: RI
authors.lastname: Riesenburger
mesh_terms: D000368:Aged; D002131:Calcium Pyrophosphate / Q000378:metabolism*; D002574:Cervical Vertebrae; D002805:Chondrocalcinosis / Q000378:metabolism / Q000473:pathology*; D000070657:Crystal Arthropathies; D006801:Humans; D007796:Laminectomy; D008022:Ligaments / Q000378:metabolism / Q000473:pathology*; D008297:Male; D019547:Neck Pain / Q000175:diagnosis / Q000209:etiology; D013116:Spinal Cord / Q000473:pathology*; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000209:etiology*; D013130:Spinal Stenosis
chemical_list: D002131:Calcium Pyrophosphate