{"id":"3a0ffa49-f88c-43ae-a57b-222864b85101","slug":"dysphagia-after-occipital-cervical-fusion-for-retro-odontoid-pseudotumor-with-ossification-of-the-anterior-longitudinal-ligament","title":"Dysphagia after occipital cervical fusion for retro-odontoid pseudotumor with ossification of the anterior longitudinal ligament","authors":["Hidenori Matsuoka","So Ohashi","Michihisa Narikiyo","Ryo Nogami","Hirokazu Nagasaki","Yoshifumi Tsuboi"],"abstract":"Background: Ossification of the anterior longitudinal ligament (OALL) of the cervical spine is a relatively rare disease. If patients present with dysphagia, hoarseness, and/or dyspnea, they may require surgery. Case Description: Over a 7-month period, a 55-year-old female with a history of cerebral palsy developed a progressive quadriparesis accompanied by diffuse sensory loss (i.e., clumsiness of the hand/legs and gait disturbance). The cervical spine X-rays showed atlanto-axial subluxation with instability, while the cervical MRI demonstrated “pseudotumor in the retro-odontoid” region. Following an occipital cervical fusion (C0-C2) surgery, her quadriparesis resolved. Nevertheless, she had persistent dysphagia that worsened over 6 months. Video fluoroscopy revealed severe mechanical stenosis of the pharynx, which was attributed to OALL extending from the C3-C6 levels. Following OALL resection through a right anterior approach utilizing diamond burrs and an ultrasonic bone curette, the dysphagia rapidly resolved. Conclusion: We report a rare case of retro-odontoid pseudotumor successfully treated with a posterior C0-C2 cervical fusion. Additional symptomatic C3-C6 OALL, responsible for progressive dysphagia, was later managed with focal anterior OALL resection.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/3a0ffa49-f88c-43ae-a57b-222864b85101/featured/hero-1781561413878.png","publishDate":"2022-04-29T00:00:00.000Z","doi":"10.25259/SNI_286_2022","categories":["Spine","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2022/04/11560/SNI-13-184.pdf"}