A Unique Case of Odontoid Metastasis Reveals Nasopharynx Carcinoma: Case Management With the Posterolateral Epidural Supra-C2-Root Approach (PESCA) Technique in Open Surgery

We present a unique case of a 21-year-old boy diagnosed with an unstable odontoid due to cavum metastasis revealed by cervicalgia and hyperextension cervical spine deformity.There were three main problems in this case: odontoid instability, the correction of cervico-occipital deformity, and histological proof.The posterior approach with the posterolateral epidural supra-C2-root approach (PESCA) resolved the situation with great improvement.This challenging finding was unusual, and in such a situation, a large review of the literature was made to make the right choice for the patient to prevent major neurological deficits and even death.