PMC9381079_01
Preoperative lateral dynamic radiographs of the cervical spine. Radiographs reveal no joint instability at C1/2. (A) Flexed position. (B) Extension position.
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The range of motion on C1/2 was 12 , indicating that there was no instability in the C1/2 joint (Fig. 1A and B).
Preoperative magnetic resonance imaging. (A) Retro-odontoid pseudotumor is iso-intense on T1-weighted sagittal image (arrow), (B) Retro-odontoid pseudotumor is hypointense on T2-weighted sagittal image (arrow). (C) Retro-odontoid pseudotumor has rim enhancement on T1-weighted gadolinium-enhanced sagittal image (arrow). (D) T1-weighted gadolinium-enhanced axial image reveals the pseudotumor extending toward the left ventral aspect (arrow). (E) T2-weighted coronal image shows compression of the left nerve root of C2 by the pseudotumor (arrow).
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T1-weighted imaging (Fig. 2A), hypointensity on T2-weighted imaging (Fig. 2B), and rim enhancement with gadolinium (Fig. 2C). The pseudotumor extended toward the left ventral aspect and compressed the left C2 nerve root (Fig. 2D and E). Celecoxib and pregabalin were prescribed for the pain, and nerve root blocks were severally performed at C2 under echographic guidance.
Intraoperative photographs. (A) Left nerve root of C2 (break lines) is compressed by the pseudotumor (arrow). (B) The pseudotumor (arrow) is resected partially.
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Moreover, the left C2 nerve root was compressed by the pseudotumor (Fig. 3A and B).