Document Detail


Spontaneous regression of periodontoid pannus mass in psoriatic atlantoaxial subluxation. Case report.
MedLine Citation:
PMID:  10101823     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY DESIGN: A case report of a 41-year-old man with psoriasis who had cervical myelopathy caused by atlantoaxial subluxation and periodontoid pannus mass. OBJECTIVE: To describe the possible mechanism underlying the periodontoid pannus formation and the optimal treatment for such cases. SUMMARY OF BACKGROUND DATA: Atlantoaxial subluxation causing spinal cord compression at the craniocervical junction may develop in patients with rheumatoid or psoriatic arthritis. Periodontoid pannus formation plays an important role in compromising the anteroposterior diameter of the spinal canal and in causing neurologic deficits. Transoral transpharyngeal excision of the pannus is sometimes thought necessary for anterior decompression of the spinal cord. Spontaneous resolution of the periodontoid pannus after posterior atlantoaxial fusion and fixation has been documented in rheumatoid arthritis, but not in psoriatic arthritis. METHODS: The patient underwent posterior atlantoaxial fusion and Halifax fixation. RESULTS: The patient experienced clinical improvement. Regression of the periodontoid pannus mass was observed on magnetic resonance imaging. CONCLUSIONS: Posterior fusion and instrumentation resulted in spontaneous regression of the pannus mass and symptomatic relief. This report provides evidence that atlantoaxial instability may be the sine qua non for the formation of periodontoid pannus, and that amelioration of such instability leads to spontaneous resolution of the pannus mass.
Authors:
K Lu; T C Lee
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Spine     Volume:  24     ISSN:  0362-2436     ISO Abbreviation:  Spine     Publication Date:  1999 Mar 
Date Detail:
Created Date:  1999-07-15     Completed Date:  1999-07-15     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  578-81     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Arthritis, Psoriatic / complications*,  pathology
Atlanto-Axial Joint / surgery*
Dislocations / complications*,  surgery*
Exudates and Transudates
Humans
Joint Instability / etiology,  surgery
Magnetic Resonance Imaging
Male
Odontoid Process / pathology*
Spinal Cord Compression / pathology*,  surgery
Spinal Fusion*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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