{"id":"694f3e37-4b18-429f-97ec-076dbe468a36","slug":"case-of-spontaneous-regression-of-dish-associated-retro-odontoid-pannus-following-occipto-cervical-fusion","title":"Case of spontaneous regression of DISH-associated retro-odontoid pannus following occipto-cervical fusion","authors":["André Luiz Girotto","Guilherme Afonso Ludwig","Camila Pereira de Souza","Guilherme da Rosa Raya","Alisson Roberto Teles"],"abstract":"Background: Retro-odontoid pannus is a reactive fibrocartilaginous mass that develops posterior to the odontoid process, causing ventral compression of the cervicomedullary junction. Although classically associated with rheumatoid arthritis, it is increasingly recognized in non-inflammatory conditions (e.g., diffuse idiopathic skeletal hyperostosis [DISH]) driven by chronic atlantoaxial instability. Over the past two decades, posterior stabilization alone has emerged as the preferred first-line approach, inducing spontaneous pannus regression by eliminating pathological motion. Case Description: An 85-year-old male with DISH and extensive subaxial cervical ankylosis presented with severe occipital/cervical pain. The magnetic resonance imaging (MRI) revealed a retro-odontoid soft-tissue mass that peripherally enhanced with gadolinium, resulting in cervicomedullary compression. Following an occipitocervical decompression/fusion (C0–C2), MRI 6 months later demonstrated spontaneous regression of the retro-odontoid mass. Conclusion: Posterior occipitocervical stabilization readily addresses degenerative retro-odontoid pannus formation attributed to DISH and may resorb following C0-C2 fusion.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/694f3e37-4b18-429f-97ec-076dbe468a36/featured/hero-1781557434771.png","publishDate":"2026-06-05T00:00:00.000Z","doi":"10.25259/SNI_477_2026","categories":["Spine","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2026/06/14601/SNI-17-339.pdf"}