Pannus is a type of extra growth in your joints that can cause pain, swelling, and damage to your bones, cartilage, and other tissue. Odontoid pannus is abnormal tissue that grows in the region of the odontoid process, a toothlike projection at the back of the second cervical vertebra in the neck. This area is the pivot point for turning your head.
If you have odontoid pannus that is causing symptoms, UPMC's team will perform a comprehensive evaluation of your condition. Our team will find the treatment approach that is the least disruptive to your brain, critical nerves, and ability to return to normal functioning.
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What Is Odontoid Pannus?
Pannus is a type of extra growth in your joints that can cause pain, swelling, and damage to your bones, cartilage, and other tissue. Odontoid pannus is abnormal tissue that grows in the region of the odontoid process, a toothlike projection at the back of the second cervical vertebra in the neck. The odontoid process serves as the pivot point for turning your head.
What are the types of odontoid pannus?
There are several types of odontoid pannus, including:
- Rheumatoid pannus — Occurs when the odontoid pannus is caused by rheumatoid arthritis.
- Odontoid synovial cyst — A similar, rare condition that occurs when a fluid-filled sac called a cyst forms near the odontoid process.
How common is odontoid pannus?
Odontoid pannus is a rare condition. However, it occurs more frequently in people with rheumatoid arthritis.
What causes odontoid pannus?
Odontoid pannus may be caused by:
- Inflammatory disorders, such as psoriatic arthritis, ankylosing spondylitis, lupus, Sjögren syndrome, gout, or pseudogout.
- Rheumatoid arthritis.
- Trauma to the neck.
Odontoid pannus risk factors
You may be at increased risk of developing odontoid pannus if you:
- Are older.
- Had a traumatic injury to your neck.
- Have been diagnosed with rheumatoid arthritis or another inflammatory condition.
Complications of odontoid pannus
If left untreated, odontoid pannus can lead to complications, including:
- Compression of the brainstem, spinal cord, and vertebral arteries.
- Sudden death.
- Paralysis.
How can I prevent odontoid pannus?
There is nothing you can do to prevent odontoid pannus.
What Are the Signs and Symptoms of Odontoid Pannus?
Symptoms of odontoid pannus may include:
- Muscle wasting.
- Pain, weakness, and difficulty moving.
- Partial paralysis.
- Quadriplegia.
When should I see a doctor about my odontoid pannus symptoms?
If you have symptoms of odontoid pannus, you should schedule an appointment with your doctor right away. Early treatment can reduce the risk of serious complications.
How Do You Diagnose Odontoid Pannus?
To diagnose odontoid pannus, your doctor will perform a physical exam and review your symptoms and medical history. Your doctor may order imaging tests to help make a diagnosis.
What to expect during your visit
During your visit, your doctor will:
- Ask about your symptoms.
- Evaluate your medical history.
- Order imaging tests.
- Perform a physical exam.
Tests to diagnose odontoid pannus
Your doctor may order imaging tests, such as:
- CT scan — A painless, noninvasive test that uses x-ray technology to capture multiple cross-sectional images of organs, bones, and tissues inside your body.
- Magnetic resonance imaging (MRI) — A safe, noninvasive imaging test that uses a magnetic field and radio waves to create images of the organs, bones, and tissues inside your body.
Odontoid pannus prognosis
With early diagnosis and treatment, most people with odontoid pannus can expect a good outcome. However, odontoid pannus that progresses and causes neurological symptoms is associated with poorer treatment outcomes.
How Do You Treat Odontoid Pannus?
If you have cervical instability and deformity as the result of odontoid pannus, but are not having neurological compression, the recommended treatment is cranio-cervical fusion to stabilize the joints.
Cranio-cervical fusion surgery
Cranio-cervical fusion surgery involves fusing the skull and bones of the cervical spine together to reduce stress on the spinal bones (vertebrae). It is typically performed as a stand-alone procedure when odontoid pannus is not causing neurological symptoms.
Fusing the joints together stabilizes the spine, prevents progression of the odontoid pannus, and reduces the risk of neurological problems.
Surgical decompression using the endoscopic endonasal approach (EEA)
Surgical decompression is required if odontoid pannus is causing compression of the spinal cord and brainstem. The EEA gives surgeons a direct way to decompress the brainstem and upper spinal cord through the nose, without making an open incision.
EEA offers the benefits of no incisions to heal, no disfigurement, and a faster recovery time.
After endonasal decompression of the spinal cord and brainstem, you will need a cranio-cervical fusion to prevent recurrence and stabilize your joints to avoid further neurological deterioration. This will address the underlying cause of the compression.
Most of the time, the EEA procedure is extradural, meaning that the lining of the brain is not opened. As a result, most patients can be safely discharged from the hospital within 1-2 days of their procedure.
Why Choose UPMC For Odontoid Pannus Care?
When you choose UPMC for odontoid pannus care, you will receive:
- Access to board-certified specialists — Our multidisciplinary team of experts provides leading-edge, minimally invasive neurosurgical care for people with odontoid pannus.
- Expert diagnosis and personalized care — Our team will develop a customized treatment plan to reduce your risk of complications and improve your quality of life.
- A full range of treatment options — We use the latest therapies and approaches to provide comprehensive care, including the minimally invasive endoscopic endonasal approach (EEA). EEA offers patients a faster recovery and fewer side effects when compared to traditional neurosurgical approaches.
