Retrodental fibrocartilaginous mass - Report of a case

Study Design. This is a report of a 63-year-old woman with a retrodental fibrocartilaginous mass and myelopathy. Objective. To describe the pathophysiology of the retrodental fibrocartilaginous mass formation and its association with the C2-C3 disc. Summary of Background Data. High cervical disc protrusion is an uncommon condition and presents even more rarely as a craniovertebral junction mass with spinal cord compression. Uncertainty remains regarding the etiology of its formation in the retrodental region. Methods. The patient underwent surgical intervention with transoral decompression and posterior C1-C2 skeletal fusion with bony graft. Results. On the basis of dynamic plain radiographs, magnetic resonance imaging, and surgical pathology, the origin of the mass may have been the C2-C3 disc. Conclusions. We hypothesized that the mechanism underlying the posterior odontoid fibrocartilaginous mass with spinal cord involvement most likely originate upward migration of the C2-C3 annulus fragment to the atlantoaxial joint as a result of aging. Secondary fibrocartilaginous metaplasia plays a major role in creating such disc-like material. To prevent unrecoverable myelopathy, early detection and anterior decompression with posterior C1-C2 skeletal fixation and body fusion are the best treatment methods.