Exuberant transverse ligament degeneration causing high cervical myelopathy

Two patients with cervical myelopathy and C1-C2 retro-odontoid masses were examined. Preoperative magnetic resonance imaging studies suggested soft ti ssue pannus, as might be seen in rheumatoid arthritis; however, the results of serologic testing for rheumatoid factor were negative in both patients. Intraoperative findings and pathologic examination revealed degenerative f ibrocartilage without inflammation or neoplasia. Similar lesions reported i n the literature have been described as retro-odontoid disk hernia, damaged transverse ligaments, transverse ligament degeneration, synovial cysts, ga nglion cysts, and degenerative articular cysts. These lesions may share a c ommon pathophysiologic origin and represent a single disease process, namel y exuberant degeneration of the transverse ligament.