ArticleSurgical neurology international2026
Case of spontaneous regression of DISH-associated retro-odontoid pannus following occipto-cervical fusion.
Article in Surgical neurology international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Retro-odontoid pannus is a reactive fibrocartilaginous mass that develops posterior to the odontoid process, causing ventral compression of the cervicomedullary junction. Although classically associated with rheumatoid arthritis, it is increasingly recognized in non-inflammatory conditions (e.g., diffuse idiopathic skeletal hyperostosis [DISH]) driven by chronic atlantoaxial instability. Over the past two decades, posterior stabilization alone has emerged as the preferred first-line approach, inducing spontaneous pannus regression by eliminating pathological motion. Case Description: An 85-year-old male with DISH and extensive subaxial cervical ankylosis presented with severe occipital/cervical pain. The magnetic resonance imaging (MRI) revealed a retro-odontoid soft-tissue mass that peripherally enhanced with gadolinium, resulting in cervicomedullary compression. Following an occipitocervical decompression/fusion (C0-C2), MRI 6 months later demonstrated spontaneous regression of the retro-odontoid mass. Conclusion: Posterior occipitocervical stabilization readily addresses degenerative retro-odontoid pannus formation attributed to DISH and may resorb following C0-C2 fusion.
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