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Retro-ondontoid pseudotumors represent soft tissue proliferation surrounding the transverse ligament of the atlas, which most commonly results in cervical neck pain or myelopathy due to impingement upon the cervicomedullary junction. The causes of retro-odontoid pseudotumor formation are varied and include metabolic, inflammatory, degenerative, and post-traumatic etiologies. To the best of our knowledge, an abducens nerve palsy as a result of a complex retro-odontoid pseudotumor has never been reported. We discuss a case of a 90-year-old woman who presents with acute lateral gaze palsy with multimodality imaging demonstrating a retro-odontoid pseudotumor with an unusual protrusion which courses superolaterally to the level of the pons and compresses the abducens nerve root entry zone.
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http://dx.doi.org/10.1016/j.radcr.2023.10.019 | DOI Listing |
J Neurosurg Case Lessons
September 2025
Department of Neurosurgery, Hospital East-Limburg, Genk, Limburg, Belgium.
Background: Calcium pyrophosphate dihydrate (CPPD) deposition disease at the craniocervical junction (CCJ) typically presents with a retro-odontoid pseudotumor. Here, the authors report a case of CPPD-induced basilar impression, causing vertebral artery (VA) dissection and hemorrhage.
Observations: A 65-year-old male presented with worsening chronic cervicalgia, occipital headaches, and unstable tandem gait.
Eur Spine J
July 2025
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Purpose: Retro-odontoid pseudotumor (ROP) is a condition characterized by benign soft tissue proliferation at the odontoid process due to mechanical stress in the atlantoaxial joint, often represented by atlantoaxial subluxation (AAS). However, the pathogenesis of ROP remains unclear, as AAS can also occur without ROP. The purpose of this study is to clarify the pathogenesis of ROP in patients with AAS by analyzing imaging findings in patients without rheumatoid arthritis who underwent surgery for AAS and/or ROP.
View Article and Find Full Text PDFJ Clin Med
June 2025
Department of Spine and Spinal Cord Surgery, School of Medicine, Fujita Health University, Toyoake 470-1192, Aichi, Japan.
A pseudotumor adjacent to the odontoid has been reported to be a non-neoplastic mass that is mainly associated with atlantoaxial instability. Case report. A 72-year-old woman presented to our clinic with a chief complaint of bilateral fine motor dysfunction and gait disturbance.
View Article and Find Full Text PDFClin Spine Surg
June 2025
Department of Orthopedics, Shanghai Changzheng Hospital, Naval Medical University, Shanghai.
Study Design: This was a retrospective study.
Objective: To retrospectively analyze the disparities in retro-odontoid soft-tissue thickness (ROSTT), cervical range of motion (ROM) and sagittal balance among patients with ossification of the posterior longitudinal ligament (OPLL) and cervical spondylotic myelopathy (CSM), while investigating the impact of cervical ROM and sagittal balance on ROSTT in the patients with OPLL.
Summary Of Background Data: The development of retro-odontoid pseudotumor (ROP) can be caused by various conditions.
Oper Neurosurg
May 2025
Department of Orthopedics, 924th Hospital of Joint Logistics Support Force of the PLA, Guilin , People's Republic of China.