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Basilar Invagination

Zuowei Wang, Xingwen Wang, Fengzeng Jian, Can Zhang, Hao Wu, Zan Chen
PURPOSE: The purpose of this study focuses on the changes of the syrinx volume after posterior reduction and fixation of the basilar invagination (BI) and atlantoaxial dislocation (AAD) with syringomyelia. METHODS: We retrospectively analyzed the clinical outcome and syrinx volume changes in 71 patients with BI, AAD and syringomyelia treated with the posterior reduction and fixation technique. RESULTS: Clinical improvement was observed in 64 (90...
August 23, 2016: European Spine Journal
Atul Goel, Trimurti Nadkarni, Abhidha Shah, Prashant Sathe, Manoj Patil
BACKGROUND: We evaluated the radiological features of 75 patients having Group B basilar invagination, meaning thereby that there was no evidence of atlantoaxial instability when measured by conventional parameter of abnormal increase in the atlantodental interval. OBJECTIVE: The variability and possible significance of presence of CSF within and outside the confines of neural tissues were specially studied. MATERIAL AND METHODS: During the period January 2008 to May 2015, we encountered 75 cases having Group B basilar invagination...
August 17, 2016: World Neurosurgery
Gong Shuhui, Liu Jiagang, Chen Haifeng, Zhao Bo Hao, Huang Si Qing
AIM: To analyze retrospectively the surgical management of reducible atlantoaxial dislocation (AAD), basilar invagination (BI) and Chiari malformation (CHM) with syringomyelia through a single-stage posterior approach. MATERIAL AND METHODS: Forty-three patients with reducible AAD, BI and CHM with syringomyelia underwent surgery from January 2009 to January 2013. Intraoperative restoration followed by posterior decompression and plate-rod placement with occipital cortical screws and C2/C3 lateral mass cortical screws fixation devices were used in all patients...
2016: Turkish Neurosurgery
Pavaman Pandit Sindgikar, Kuntal Kanti Das, Awadesh K Jaiswal, Rabi Narayan Sahu, Arun K Srivastava, Anant Mehrotra, Jayesh Chunilal Sardhara, Kamlesh Singh Bhaisora, Sanjay Behari
INTRODUCTION: Surgery for craniovertebral junction (CVJ) abnormalities like atlantoaxial dislocation (AAD) with or without basilar invagination (BI) and/or with or without associated Arnold-Chiari malformation (ACM) cause high cervical myelopathy. Occasionally, mechanical factors such as inadequate canal decompression, torticollis, and/or scoliosis may lead to lack of improvement following the primary surgery. Also, implant-related factors requiring its revision/removal or surgical site infections may cause patient to undergo resurgery...
August 2016: Neurosurgery
Nandor K Pinter, Jennifer McVige, Laszlo Mechtler
The congenital and acquired deformities of the craniovertebral junction (CVJ), such as basilar invagination, basilar impression, or platybasia, can present in the form of slowly progressive or acute neurologic deterioration. In many cases, an insidious headache is the only symptom and can be a diagnostic challenge for the neurologist. Proper imaging studies as well as recognizing often associated neurologic or systemic conditions are required for early diagnosis and effective therapy. In the current report, the primary focus will be on clinical aspects of these CVJ abnormalities; the pathologic and radiologic aspects, such as developmental and pathophysiologic background or radiographic analysis, will be discussed briefly, confined to clinically relevant data...
August 2016: Current Pain and Headache Reports
Atul Goel
STUDY DESIGN: Four patients had C2-3 vertebral fusion and radiologically demonstrated cord compression at C3-4 level related to disc bulge with or without association of osteophytes and C1-2 posterior facetal dislocation. The outcome of treatment by atlantoaxial and subaxial facetal fixation is discussed. PURPOSE: The article evaluates the significance of atlantoaxial facetal instability in cases having C2-3 vertebral fusion and cord compression at the level of C3-4 disc...
June 2016: Asian Spine Journal
Sushil Patkar
Unilateral anterior retropharyngeal approach was used in a case of basilar invagination with atlanto-axial instability. This approach provided easy access to both atlanto-axial joints. Wedge-shaped titanium cages were used to distract the joints and reduce the basilar invagination. Titanium plates with screws were used to fix the lateral mass of atlas with the body of axis, bilaterally. The anterior atlanto-axial joint distraction procedure has not been described in literature before seems to be an easy option in selected cases of craniovertebral anomalies and needs to be investigated by more surgeons...
August 2016: Neurological Research
Yi Liao, Lati Pu, Hailong Guo, Erdan Mai, Weidong Liang, Qiang Deng, Tao Xu, Jun Sheng, Weibin Sheng
BACKGROUND CONTEXT: BI is a malformation of craniovertebral junction (CVJ). However, surgical procedures on basilar invagination (BI) with atlantoaxial dislocation (AAD) remain controversial. PURPOSE: This research aimed to investigate the selection of surgical procedures and its significance in the surgical treatment for patients with BI and AAD. STUDY DESIGN: This was a retrospective study. PATIENT SAMPLE: This study enrolled thirty-three patients who were diagnosed with BI and AAD and were followed up for at least six months...
June 9, 2016: Spine Journal: Official Journal of the North American Spine Society
S Xu, R Gong
AIM: To investigate whether clivus height (CH; the distance of the basion above Chamberlain's line) could be used to diagnose basilar invagination (BI) at computed tomography (CT). MATERIALS AND METHODS: This retrospective study received institutional review board approval, and was performed from 1 January 2013, to 1 July 2015 with a waiver of informed consent. CH was measured on mid-sagittal reconstructed CT images from 65 BI patients and 85 control subjects to compare the two groups by using the independent-samples t-test...
November 2016: Clinical Radiology
Francien A de Leeuw, Dominique C de Lange, Cathelijne W Y Appels
A 78-year-old woman with a history of rheumatoid arthritis has been developing progressive speech and swallowing problems since 3 weeks. A CT scan of her head and neck showed a subluxation of the dens, which caused basilar invagination. This severe complication of rheumatoid arthritis is rare. Dynamic imaging and neurologic survey are recommended in patients with rheumatoid arthritis.
2016: Nederlands Tijdschrift Voor Geneeskunde
Laxminadh Sivaraju, Sunithi Mani, Krishna Prabhu, Roy Thomas Daniel, Ari George Chacko
PURPOSE: To describe vertebral artery (VA) course at the C0-C1-C2 complex in patients with congenital bony craniovertebral junction (CVJ) anomalies. METHODS: We studied the course of 169 VAs in 86 patients with congenital bony CVJ anomalies [basilar invagination (42), os odontoideum (33), and irreducible atlantoaxial dislocation (11)]. Occipitalized atlas occurred in 41 patients (30 complete and 11 partial). Using axial, coronal and sagittal three-dimensional computed tomography (3D-CT) angiograms, we traced the VA bilaterally at the CVJ and correlated the course to the presence or absence of occipitalization of the atlas...
May 2, 2016: European Spine Journal
Timothy T Roberts, Daniel J Cepela, Richard L Uhl, Jeffery Lozman
Osteogenesis imperfecta is a heritable group of collagen-related disorders that affects up to 50,000 people in the United States. Although the disease is most symptomatic in childhood, adults with osteogenesis imperfecta also are affected by the sequelae of the disease. Orthopaedic manifestations include posttraumatic and accelerated degenerative joint disease, kyphoscoliosis, and spondylolisthesis. Other manifestations of abnormal collagen include brittle dentition, hearing loss, cardiac valve abnormalities, and basilar invagination...
May 2016: Journal of the American Academy of Orthopaedic Surgeons
Pravin Salunke, Sushanta K Sahoo, Sudhir Sood, Kanchan K Mukherjee, Sunil K Gupta
OBJECTIVES: Occipito-cervical(OC) fusion is often practiced for congenital atlanto-axial dislocation (CAAD) and basilar invagination (BI) with claims of good long term outcome. Little has been discussed about the delayed complications following fusing occipital squama to cervical spine (OC fusion). We have described and analyzed delayed complications with OC fusion in our patients that helps us understand the underlying dynamics and biomechanics. PATIENTS AND METHODS: Twenty seven patients of CAAD and BI underwent OC fusion (between 2008 and 11) after transoral odontoidectomy or direct posterior reduction with OC distraction...
June 2016: Clinical Neurology and Neurosurgery
Pravin Salunke, Sushanta K Sahoo, Arsikere N Deepak, Ravi Garg
BACKGROUND: Congenital atlantoaxial dislocation has been commonly described in the antero-posterior or vertical plane (basilar invagination). However, dislocation in the lateral translational plane due to congenital deformity is rare. CASE REPORT: We present a case of a young male who presented with os odontoideum with C1-2 dislocation in the lateral plane along with antero-posterior dislocation. He was operated on through a midline posterior incision, and the C1-2 facet was manipulated so as to correct the dislocation in all planes...
2016: Pediatric Neurosurgery
Gejin Wei, Zhiyun Wang, Fuzhi Ai, Qingshui Yin, Zenghui Wu, Xiang Yang Ma, Junjie Xu, Chenglong Shi, Hong Xia
BACKGROUND: Klippel-Feil syndrome (KFS) is characterized by congenital vertebral fusion of the cervical spine and a wide spectrum of associated anomalies. In patients with KFS with basilar invagination (BI), compression of the brainstem and upper cervical cord results in neurological deficits, and decompression and occipitocervical reconstruction are required. The highly varied anatomy of KFS makes a posterior occipitocervical fixation strategy challenging. For these patients, the transoral atlantoaxial reduction plate (TARP) operation is an optimal option to perform a direct anterior fixation to achieve stabilization...
April 2016: Neurosurgery
Lin-Nan Wang, Qiu-Nan Lv, Lei Wang, Yue-Ming Song
No abstract text is available yet for this article.
March 11, 2016: Spine Journal: Official Journal of the North American Spine Society
Sudhir Kumar Srivastava, Pradip Sharad Nemade, Rishi Anil Aggarwal, Sunil Krishna Bhoale
Developmental anomalies of the axis are commonly encountered, especially anomalies involving the odontoid process. Anomalies of the posterior elements are uncommon. We describe a unique case of agenesis of posterior elements of C2 with basilar invagination and atlanto-axial dislocation. An obese 8-year-old boy presented with symptoms of cervical myelopathy. Radiological workup revealed a craniovertebral junction anomaly with occipitalised atlas, absent posterior elements of axis, and hypertrophied C3 spinous process...
February 2016: Asian Spine Journal
Shuaishuai Xu, Ruozhen Gong
STUDY DESIGN: Retrospective study. OBJECTIVE: To investigate whether clivodens angle (CDA) could diagnose basilar invagination (BI) at computed tomography (CT). SUMMARY OF BACKGROUND DATA: Over the years, multiple craniometric methods such as Chamberlain line, McGregor line, McRae line, Wackenheim clivus baseline, and Welcher basal angle have been described for evaluation of craniovertebral junction anomalies, initially with radiography and later with CT...
September 2016: Spine
Tao Xu, Pulati Maimaiti, Hailong Guo, Maierdan Maimaiti, Jun Sheng, Weidong Liang, Qiang Deng, Chuanhui Xun, Jian Zhang, Weibin Sheng
OBJECTIVE: To evaluate the indications and effect of surgical treatment of basilar invagination (BI) with atlantoaxial dislocation (AAD) on the basis of retrospective analysis of the clinical and imaging data of patients. METHODS: Consecutive 21 patients with BI and AAD were surgically treated in Department of Spinal Surgery, The First Affiliated Hospital of Xinjiang Medical University from July 2000 to December 2013. There were 10 males and 11 females, aged from 7 to 59 years, with a mean of 36...
September 15, 2015: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Yiheng Yin, Xinguang Yu, Huaiyu Tong, Tao Xu, Peng Wang, Guangyu Qiao
OBJECTIVE: To investigate the clinical application value of the 3D printing technique in the treatment of basilar invagination and atlantoaxial dislocation. METHODS: From January 2013 to September 2013, 10 patients with basilar invagination and atlantoaxial dislocation needing posterior fixation undertook 3D printing modes at the Department of Neurosurgery in PLA General Hospital. The 1:1 size models were established from skull base to C4 level with different colors between bone structures and vertebral arteries...
October 6, 2015: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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