{"id":"87ac024f-934a-4ce7-9375-3c11e900f936","slug":"symptomatic-retro-odontoid-pseudotumor-regressing-after-strict-immobilization-with-a-soft-cervical-collar-a-case-report","title":"Symptomatic retro-odontoid pseudotumor regressing after strict immobilization with a soft cervical collar: A case report","authors":["Masahiro Kawanishi","Naokado Ikeda","Yutaka Ito","Kunio Yokoyama","Makoto Yamada","Akira Sugie","Hidekazu Tanaka"],"abstract":"Background: Symptomatic retro-odontoid pseudotumor (ROP) causing cervical myelopathy is generally treated surgically because of the risk of neurological deterioration. However, here, we present an 82-year-old female in whom stabilization for 6 months in a soft cervical collar results in mass and symptom regression. Case Description: An 82-year-old female developed a right hemiparesis. Her deficit was attributed to a cervical magnetic resonance imaging (MRI) that demonstrated a T2-hypointense retro-odontoid mass compressing the spinal cord, causing intramedullary T2 hyperintensity. Posterior surgical stabilization/decompression was recommended, but she declined surgery. She was treated with a soft cervical collar and gradually improved. Over 6 months, the right incomplete hemiparesis resolved. The follow-up MRI demonstrated spontaneous regression of the retro-odontoid mass, resolution of cord compression, and no residual hyperintense T2 cord signal. She remains stable and asymptomatic 2 years later. Conclusion: Although surgery remains the standard for symptomatic ROP, strict cervical immobilization – even with a soft collar – may be a reasonable option in selected (i.e., particularly elderly) patients.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/87ac024f-934a-4ce7-9375-3c11e900f936/featured/hero-1781557870697.png","publishDate":"2026-02-20T00:00:00.000Z","doi":"10.25259/SNI_1391_2025","categories":["Spine","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2026/02/14328/SNI-17-102.pdf"}