Massive obstruction of the spinal canal and progressive cervical myelopathy due to osseous hypertrophy of a facet joint : a case report

Abstract

Cervical spondylotic myelopathy is one of the most common causes of cervical spinal cord dysfunction. A 65-year-old patient was admitted with slowly-progressing myelopathic symptoms. Imaging studies indicated a massive lesion, which was thought to be a primary bone tumor. Laminectomy and microsurgical resection of the suspected lesion with a posterior approach at the C4 level was performed. Histopathological examination showed a hypertrophic facet joint. Age-related degenerative changes and adaptation mechanisms result in hypertrophy of the joint and synovial cyst formation. In our case, it was enormous and could be easily mistaken for a tumorous process. Such extensive hypertrophic changes are rarely addressed in the literature and should be considered as a differential diagnosis.