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MRI Findings: Cervical Spondylotic Myelopathy with Cord Compression

Written by Faisel S. Taleb, MD and Michael G. Fehlings, MD

Suboccipital Cervical Decompression, Reconstruction, and Instrumented Fusion using 3-dimensional Computer-assisted Frameless Stereotactic Navigation System

MRI scans showed evidence of a pannus at the C1-C2 level with significant cord compression and subaxial spondylosis with cord compression.

Preop MRI T1, large pannus at C1-C2, cord compression, subaxial spondylosis
Figure 2A

Preop MRI T1, large pannus at C1-C2, cord compression, subaxial spondylosis
Figure 2B

Figure 2A-B. Preoperative MRI T1 with (upper view) and without (lower view) Gad. Large pannus at C1-C2 with significant cord compression, and subaxial spondylosis with cord compression.

Preop MRI T1, axial cuts at C1-C2 pannus, cord compression
Figure 3A

Figure 3B

Figure 3A-B. MRI T1 Axial cuts at C1-C2 level. Without (upper view) and with (lower view) Gad. Showing pannus compressing the spinal cord.

Preop MRI T2, sagittal view, pannus at C1-C2, cord compression, subaxial spondylosis
Figure 4. MRI T2. Preoperative sagittal view showing pannus at C1-C2 with significant cord compression and subaxial spondylosis with cord compression.

Diagnosis
Progressive cervical myelopathy with pannus at C1-C2 level with significant cord compression and subaxial spondylosis with cord compression.

A retro-odontoid non-neoplastic lesion associated chronic atlantoaxial subluxation is considered to be a pseudotumor and may present with or without instability.

The etiology of the pseudotumor remains controversial. An inflammatory pseudotumor is an idiopathic condition characterized by sclerosing inflammation, which mimics a neoplastic process. It is a rare condition and is usually indistinguishable from aggressive neoplasms or infection.

Updated on: 12/10/09