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Preoperative Cyst Formation as a Predictive Feature of Spontaneous Regression of Retro-Odontoid Pseudotumor After Posterior Fusion
- Source :
- World Neurosurgery. 150:e491-e499
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Although the spontaneous regression of pseudotumors after posterior fusion has been reported, the predictive factors remain unclear. We examined the radiological features that predict for the regression of retro-odontoid pseudotumors after posterior fusion, with a specific focus on cyst formation.We included 28 patients with a diagnosis of retro-odontoid pseudotumor using preoperative magnetic resonance imaging. The radiographic parameters and pseudotumor thickness were measured pre- and postoperatively. The regression rate for each pseudotumor was calculated. The presence of a cyst around the retro-odontoid pseudotumor was investigated. If present, the cyst thickness was measured. To elucidate the predictors for the postoperative regression of pseudotumors, the patients were divided into 2 cohorts: the regression group with a regression rate40% and the no-regression group with a regression rate of40%. Multivariate logistic regression analysis, including the demographic data and preoperative radiographic parameters as independent variables, was performed.The mean pseudotumor size had decreased significantly from 8.8 ± 3.6 mm preoperatively to 5.3 ± 2.0 mm postoperatively (P0.0001). The mean regression rate was 35.9% during a magnetic resonance imaging follow-up period of 8.6 months (range, 6-12 months). Cystic lesions were noted in 10 patients (35.7%) preoperatively. The mean cyst size was 4.7 ± 1.9 mm. All cysts were located dorsal to the pseudotumors and were involved at the maximum spinal compression levels. Nevertheless, all the cysts had disappeared postoperatively. Multivariate logistic regression analysis revealed that the pseudotumor regression group had had a significantly greater proportion of cysts (57.1% vs. 14.3%; odds ratio, 11.7; P = 0.013).The presence of cystic lesions protruding from retro-odontoid pseudotumors might serve as a predictive factor for the spontaneous regression of pseudotumors after posterior fusion.
- Subjects :
- Male
medicine.medical_specialty
Radiography
Remission, Spontaneous
Regression rate
03 medical and health sciences
0302 clinical medicine
Odontoid Process
medicine
Humans
Cyst
Aged
Retrospective Studies
Posterior fusion
medicine.diagnostic_test
Cysts
business.industry
Magnetic resonance imaging
Middle Aged
medicine.disease
Regression
Predictive factor
stomatognathic diseases
Spinal Fusion
Atlanto-Axial Joint
030220 oncology & carcinogenesis
Cyst formation
Female
Spinal Diseases
Surgery
Neurology (clinical)
Radiology
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 18788750
- Volume :
- 150
- Database :
- OpenAIRE
- Journal :
- World Neurosurgery
- Accession number :
- edsair.doi.dedup.....ced3a7a312a65edc299799a8d6f0aff7