{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T09:50:04Z","timestamp":1793699404101,"version":"4.5.1"},"reference-count":70,"publisher":"The Korean Spinal Neurosurgery Society","issue":"4","license":[{"start":{"date-parts":[[2021,12,31]],"date-time":"2021-12-31T00:00:00Z","timestamp":1640908800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["e-neurospine.org"],"crossmark-restriction":true},"short-container-title":["Neurospine"],"published-print":{"date-parts":[[2021,12,31]]},"abstract":"<jats:p>The retro-odontoid pseudotumor is often concurrent with atlantoaxial subluxation (AAS). Therefore, the pseudotumor is relatively common in rheumatoid arthritis (RA) but rare in primary osteoarthritis (OA). This is a case report of an elderly male patient suffering from neck pain and compression myelopathy caused by the craniocervical pseudotumor with OA but without atlantoaxial instability. He had long-lasting peripheral and spinal pain treated by nonsteroidal anti-inflammatory drugs. Imaging found upper cervical spondylosis without AAS or dynamic instability but with periodontoid calcifications and ossifications, suggesting calcium pyrophosphate dihydrate (CPPD) crystal deposition. Based on a comprehensive literature search and review, CPPD disease around the atlantodental joint is a possible contributor to secondary OA development and retro-odontoid pannus formation through chronic inflammation, which can be enough severe to induce compression myelopathy in non-RA patients without AAS. The global increase in the aged population advises caution regarding more prevalent upper cervical spine disorders associated with OA and CPPD.<\/jats:p>","DOI":"10.14245\/ns.2142112.056","type":"journal-article","created":{"date-parts":[[2021,12,29]],"date-time":"2021-12-29T05:10:58Z","timestamp":1640754658000},"page":"903-913","update-policy":"https:\/\/doi.org\/10.14245\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Upper Cervical Compression Myelopathy Caused by the Retro-Odontoid Pseudotumor With Degenerative Osteoarthritis and Calcium Pyrophosphate Dihydrate Disease: A Case Report and Literature Review"],"prefix":"10.14245","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3007-361X","authenticated-orcid":true,"given":"Takashi","family":"Yurube","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuhiro","family":"Iguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Kinoshita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Sadamitsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenichiro","family":"Kakutani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"5355","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-019-03187-z"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.165.3.7645475"},{"key":"ref3","first-page":"647","volume-title":"Progression of cervical spine instabilities in rheumatoid arthritis: a prospective cohort study of outpatients over 5 years","author":"Yurube","year":"2011"},{"key":"ref4","first-page":"2136","volume-title":"Incidence and aggravation of cervical spine instabilities in rheumatoid arthritis: a prospective minimum 5-year follow-up study of patients initially without cervical involvement","author":"Yurube","year":"2012"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0088970"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.54.9.817"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.181429"},{"key":"ref8","first-page":"1303","volume-title":"Hypertrophic dens resulting in cervical myelopathy: histologic features of the hypertrophic dens","author":"Okada","year":"2000"},{"key":"ref9","first-page":"E520","volume-title":"Mobile and reducible atlantoaxial dislocation in presence of occipitalized atlas: report on treatment of eight cases by direct lateral mass plate and screw fixation","author":"Goel","year":"2004"},{"key":"ref10","first-page":"39","volume-title":"Cervical myelopathy with retroodontoid pseudotumor caused by atlantoaxial rotatory fixation and senile tremor","author":"Watanabe","year":"2009"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/238748"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(19)30417-9"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2011.199"},{"key":"ref14","first-page":"687","volume-title":"Anteroposterior atlantoaxial subluxation in cervical spine osteoarthritis: case reports and review of the literature","author":"Daumen-Legre","year":"1999"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2018.10.011"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1136\/bcr.11.2011.5178"},{"key":"ref17","first-page":"173","volume-title":"Atlantoaxial subluxation in systemic lupus erythematosus: further evidence of tendinous alterations","author":"Babini","year":"1990"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.171251"},{"key":"ref19","first-page":"1763","volume-title":"Postoperative regression of retro-odontoid pseudotumor after atlantoaxial posterior fixation: 11 years of experience in patients with atlantoaxial instability","author":"Park","year":"2017"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.13004\/kjnt.2016.12.2.180"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.5334\/jbsr.1587"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2009.07.116"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0b013e31818acd27"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.3171\/spi.2002.96.2.0190"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200205150-00024"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-007-0508-6"},{"key":"ref27","first-page":"277","volume-title":"Osteoarthritis of the alantoaxial joint","author":"Harata","year":"1981"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.154.2.2105022"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1177\/0284185113492722"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2014.09.011"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1007\/bf00593391"},{"key":"ref32","first-page":"434","volume-title":"Occipito-atlanto-axial osteoarthritis: a cross sectional clinico-radiological prevalence study in high risk and general population","author":"Badve","year":"2010"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.13130125"},{"key":"ref34","first-page":"401","volume-title":"Factors influencing on retro-odontoid soft-tissue thickness: analysis by magnetic resonance imaging","author":"Tojo","year":"2013"},{"key":"ref35","first-page":"1467","volume-title":"Myelopathy resulting from the atlantodental hypertrophic osteoarthritis accompanying the dens hypertrophy. Two case reports","author":"Sato","year":"1996"},{"key":"ref36","first-page":"137","volume-title":"Atlantodental osteoarthritis as a cause of upper cervical myelopathy: a case report","author":"Eren","year":"2008"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.3171\/2009.12.spine0999"},{"key":"ref38","first-page":"369","volume-title":"Destructive spondylarthropathy in hemodialyzed patients. A new syndrome","author":"Kuntz","year":"1984"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1007\/s002560100389"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1056\/nejmra1511117"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(197605\/06)19"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23160"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200106150-00027"},{"key":"ref44","doi-asserted-by":"publisher","DOI":"10.3171\/spi-08\/01\/022"},{"key":"ref45","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199311000-00005"},{"key":"ref46","first-page":"430","volume-title":"Calcium pyrophosphate dehydrate crystal deposition in the ligamentum flavum of the cervical spine: histopathological and immunohistochemical findings","author":"Mwaka","year":"2009"},{"key":"ref47","doi-asserted-by":"publisher","DOI":"10.31616\/asj.2018.12.6.1117"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.1136\/ard.55.2.137"},{"key":"ref49","doi-asserted-by":"publisher","DOI":"10.1007\/s11547-007-0135-7"},{"key":"ref50","doi-asserted-by":"publisher","DOI":"10.1097\/rhu.0b013e3181c9484f"},{"key":"ref51","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2019.06.050"},{"key":"ref52","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2013.07.007"},{"key":"ref53","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1996.85.5.0803"},{"key":"ref54","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-006-0273-3"},{"key":"ref55","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2017.07.008"},{"key":"ref56","first-page":"2372","volume-title":"Cervical myelopathy caused by calcium pyrophosphate dihydrate crystal deposition in facet joints. A case report","author":"Omura","year":"1996"},{"key":"ref57","doi-asserted-by":"publisher","DOI":"10.1017\/cjn.2018.319"},{"key":"ref58","doi-asserted-by":"publisher","DOI":"10.2106\/jbjs.cc.18.00329"},{"key":"ref59","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-004-0856-4"},{"key":"ref60","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0b013e31815d004c"},{"key":"ref61","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-013-3004-1"},{"key":"ref62","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0000000000001783"},{"key":"ref63","first-page":"455","volume-title":"Regression of retroodontoid pseudotumors following C-1 laminoplasty. Report of three cases","author":"Suetsuna","year":"2006"},{"key":"ref64","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-013-2681-0"},{"key":"ref65","doi-asserted-by":"publisher","DOI":"10.1097\/bsd.0b013e31829eb7e6"},{"key":"ref66","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-018-5573-5"},{"key":"ref67","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2012.03.012"},{"key":"ref68","doi-asserted-by":"publisher","DOI":"10.1097\/bsd.0b013e318277da19"},{"key":"ref69","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2012.03.013"},{"key":"ref70","doi-asserted-by":"publisher","DOI":"10.1080\/02688697.2018.1538485"}],"container-title":["Neurospine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/e-neurospine.org\/upload\/pdf\/ns-2142112-056.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-neurospine.org\/journal\/view.php?doi=10.14245\/ns.2142112.056","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-neurospine.org\/upload\/pdf\/ns-2142112-056.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,29]],"date-time":"2021-12-29T05:15:02Z","timestamp":1640754902000},"score":1,"resource":{"primary":{"URL":"http:\/\/e-neurospine.org\/journal\/view.php?doi=10.14245\/ns.2142112.056"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,31]]},"references-count":70,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,12]]}},"URL":"https:\/\/doi.org\/10.14245\/ns.2142112.056","relation":{},"ISSN":["2586-6583","2586-6591"],"issn-type":[{"value":"2586-6583","type":"print"},{"value":"2586-6591","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,31]]},"assertion":[{"value":"2021-01-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-31","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-31","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}