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Basilar Invagination

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https://www.readbyqxmd.com/read/29777893/influence-of-postoperative-o-c2-angle-on-the-development-of-dysphagia-after-occipitocervical-fusion-surgery-results-from-a-retrospective-analysis-and-prospective-validation
#1
Xingwen Wang, Dean Chou, Fengzeng Jian
BACKGROUND: Postoperative dysphagia is a known complication of anterior cervical surgery, but its incidence and possible mechanisms are seldom reported after occipitocervical fusion (OCF). Our objective was to study the relationship between craniocervical alignment and the development of dysphagia after OCF for the treatment of basilar invagination with atlantoaxial instability. METHODS: The study was consisted of a retrospective series and a prospective series...
May 16, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29775769/quality-of-life-after-combined-endonasal-endoscopic-odontoidectomy-and-posterior-suboccipital-decompression-and-fusion
#2
Malte Ottenhausen, Andrew F Alalade, Kavelin Rumalla, Prakash Nair, Ali Baaj, Roger Hartl, Ashutosh Kacker, Jeffrey P Greenfield, Vijay K Anand, Theodore H Schwartz
INTRODUCTION: Basilar invagination can result from a variety of systemic diseases that can weaken the structural integrity of the craniocervical junction. Definitive treatment often requires ventral decompression along with posterior decompression and fusion. Endonasal odontoidectomy is a relatively new minimal access procedure, however, quality of life after this procedure has not been reported. METHODS: We reviewed a consecutive database of endonasal odontoidectomy patients and identified those having posterior decompression and fusion...
May 15, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29731280/-sandwich-deformity-in-klippel-feil-syndrome-a-full-spectrum-presentation-of-associated-craniovertebral-junction-abnormalities
#3
Yinglun Tian, Dongwei Fan, Nanfang Xu, Shenglin Wang
Klippel-Feil syndrome (KFS) is defined as congenital fusion of two or more cervical vertebrae resulting from a segmentation failure in the developing spine. According to Samartzis et al., the most commonly fused segments are found at C2/3 (74.1%) and C6/7 (70.4%). In patients with C2/3 fusion, especially when there is additional C1 occipitalization, several secondary anomalies including atlantoaxial dislocation (AAD), basilar invagination (BI), Chiari malformation, and syringomyelia can be identified. In this report, we present a case of a 12-year-old patient with C2/3 and occipitalization and a "Full-Spectrum" presentation of associated CVJ abnormalities including C0/1 fusion, AAD, BI, Chiari malformation, syringomyelia, myelopathy and cranial neuropathy received neurological decompression of the cervico-medullary junction by posterior reduction of the AAD and reconstruction of her CVJ using an unconventional hybrid construct due to a high-riding right vertebral artery in C2...
May 3, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29678713/posterior-fossa-epidural-hematomas-a-rare-but-serious-complication-of-occipito-cervical-fusion-surgery
#4
Chang Rong Zhu, Jianhua Wang, Dai Jianqiang, Kun Chen, Xia Hong
BACKGROUND: Posterior occipito-cervical fusion surgery is a commonly used surgical method to treat various craniovertebral junction pathologies. Though it is an effective method, there also have been some reports about complications of occipito-cervical fusion. However, there have been no reports about posterior fossa epidural hematomas after occipito-cervical fusion. CASE DESCRIPTION: A 44-year-old female was referred to our Hospital with a 6-month history of neck pain and numbness limbs for 2 months...
April 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29664878/c2-translaminar-screw-fixation-in-children
#5
Brian W Yang, Michael P Glotzbecker, Michael Troy, Mark R Proctor, Michael T Hresko, Daniel J Hedequist
BACKGROUND: Axis (C2) screw fixation has been shown to be effective in treating disorders that necessitate cervical stabilization. Although translaminar C2 screws have demonstrated clinical efficacy in adults, this technique has not yet been thoroughly investigated in children. This study describes the indications, technique, and results of translaminar C2 screw fixation in a case series of pediatric cervical spine disorders. METHODS: We searched the orthopaedic database at our institution for patients who had undergone a cervical spinal fusion that encompassed C2 between 2007 and 2017...
April 16, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29545218/management-issues-in-a-case-of-congenital-cv-junction-anomaly-with-aberrant-retropharyngeal-midline-course-of-bilateral-cervical-icas-at-c1-c2
#6
Narayanam Anantha Sai Kiran, Veldurti Ananta Kiran Kumar, Laxminadh Sivaraju, Valluri Anil Kumar, Chintakunta Rajesh Reddy, Amit Agrawal
BACKGROUND: Aberrant medial retropharyngeal prevertebral course of internal carotid arteries (ICAs) is extremely uncommon. In oropharyngeal surgeries like trans oral odontoidectomy (TOO) this unrecognized aberrant retropharyngeal course of ICAs can result in devastating complications secondary to inadvertent injury of ICAs. Authors describe this aberrant course of ICAs in a patient with craniovertebral junction (CVJ) anomaly with dysmorphic C1 lateral mass on one side and discuss in detail various management issues in this complex case...
March 12, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29538039/endoscopic-endonasal-approach-to-the-upper-cervical-spine-for-decompression-of-the-cervicomedullary-junction-following-occipitocervical-fusion
#7
Ibrahim Hussain, Theodore H Schwartz, Jeffrey P Greenfield
Basilar invagination is defined as abnormal upward and/or posterior displacement of the odontoid leading to ventral compression of the cervicomedullary junction. This condition leads to lower cranial neuropathies, sensorimotor deficits, and myelopathy. These symptoms can persist even after posterior decompression, which is an indication for ventral decompression. Transoral approaches to the upper cervical spine carry significant morbidity, limiting their utility. The endonasal approach to the upper cervical spine presents an alternative for patients with amenable anatomy...
March 13, 2018: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29530685/computed-tomography-imaging-study-of-basilar-invagination-and-atlantoaxial-dislocation
#8
Zhi-Yuan Xia, Wan-Ru Duan, Xing-Hua Zhao, Feng-Zeng Jian, Zan Chen
OBJECTIVE: We sought to analyze axis deformities and the biomechanics related to atlantoaxial dislocation (AAD) in patients with basilar invagination (BI). METHODS: Seventy-six patients were retrospectively analyzed including 21 patients who had BI (group B), 32 patients with BI and AAD (group C), and 23 nondeformity control subjects (group A). Using 3-dimensional computed tomography imaging the distance from the tip of the dens above the Chamberlain line in the sagittal plane, atlantodental interval, sagittal inclination, coronal inclination, and craniocervical tilt, the height of the odontoid and ratio of the height to the odontoid basal width were measured in each patient...
March 10, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29526072/additional-surgical-method-aimed-to-increase-distractive-force-during-occipitocervical-stabilization-technical-note
#9
Veysel Antar, Okan Turk
OBJECTIVE: Craniovertebral junctional anomalies constitute a technical challenge. Surgical opening of atlantoaxial joint region is a complex procedure especially in patients with nuchal deformity like basilar invagination. This region has actually very complicated anatomical and functional characteristics, including multiple joints providing extension, flexion, and wide rotation. In fact, it is also a bottleneck region where bones, neural structures, and blood vessels are located. Stabilization surgery regarding this region should consider the fact that the area exposes excessive and life-long stress due to complex movements and human posture...
March 2018: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29524722/is-anatomic-reduction-better-than-partial-reduction-in-patients-with-vertical-atlantoaxial-dislocation
#10
Qing Wang, Xinjie Wu, Mingsheng Tan, Gaoju Wang, Shuang Xu, Yingna Qi
OBJECTIVE: To describe lower cranial nerve (CN) palsy following vertical overdistraction when performing occipitocervical fusion (OCF) to treat vertical atlantoaxial dislocation (AAD) and basilar invagination (BI) and investigate its possible causes. METHODS: We report 4 cases with vertical AAD and BI who presented postoperatively with neurogenic dysphagia, dysarthria, and bucking after undergoing anatomic reduction. RESULTS: Patients underwent revision surgery to achieve partial reduction and demonstrated remarkable recovery of CN IX, X, and XI deficits...
March 7, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29433185/c1-2-and-c2-3-instability-in-the-presence-of-hypoplastic-posterior-elements-of-c2-vertebra-report-of-2-cases
#11
Atul Goel, Apurva Prasad, Abhidha Shah, Sandeep More
BACKGROUND: We present 2 cases involving a previously unreported clinical situation in which basilar invagination, atlantoaxial instability, and C2-3 instability were associated with a bifid posterior arch of the axis bone. CASE DESCRIPTIONS: Two young males presented with limb weakness, spasticity, and paresthesias. Both patients had altered voice quality, with reduced and thin volume, and difficulty sleeping supine. Radiologic imaging showed an absence of the posterior elements of the C2 vertebrae...
February 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29433178/radiological-evaluation-of-510-cases-of-basilar-invagination-with-evidence-of-atlantoaxial-instability-group-a-basilar-invagination
#12
Atul Goel, Sonal Jain, Abhidha Shah
OBJECTIVE: To evaluate the musculoskeletal and soft tissue neural alterations in cases with group A basilar invagination. METHODS: Between January 2007 and August 2016, 510 patients with group A basilar invagination were surgically treated. The radiologic images of these patients were reviewed retrospectively. The patients were divided into 4 groups: group A1, comprising 60 patients with syringomyelia; group A2, comprising 354 patients with "external syrinx," marked by excessive cerebrospinal fluid (CSF) in the extramedullary space; group A3, comprising 51 patients with both syringomyelia and external syrinx; and group A4, comprising 45 patients with no abnormality of CSF cavitation in the spinal canal...
February 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29322984/a-device-for-three-dimensional-quantitative-assessment-and-alignment-of-c1-2-vertebrae-during-posterior-distraction-and-fusion-technique-for-atlantoaxial-dislocation-and-or-basilar-invagination
#13
P B Karthik, Jayesh Sardhara, Nachiketa Tiwari, Sanjay Behari
The most common type of congenital C1-2 dislocation is a combined type in which atlanto-axial dislocation (AAD) and basilar invagination (BI) are often associated with a rotational dislocation and coronal tilt. An optimal surgical treatment involves reduction of AAD and BI with simultaneous correction of the rotation and coronal tilt to achieve an optimal cervical canal decompression, sagittal and coronal realignment and bony fusion. The most acceptable technique to facilitate this correction is the C1-C2 distraction technique, which is accomplished by the manual joint manipulation...
January 2018: Neurology India
https://www.readbyqxmd.com/read/29303466/delayed-neurological-deterioration-following-atlantoaxial-facet-joint-distraction-and-fixation-in-a-patient-with-chiari-malformation-type-i
#14
Tatsushi Inoue, Natsuki Hattori, Tsukasa Ganaha, Tadashi Kumai, Shinichiro Tateyama, Yuichi Hirose
Chiari malformation type I (CM-I) is typically treated with foramen magnum decompression. However, a recent study proposed a new technique for patients with CM-I, wherein only short atlantoaxial joint fusion and distraction is applied. Posterior fusion with or without atlantoaxial distraction is a potential option for patients with CM-I associated with basilar invagination or complex anomalous bony craniovertebral junction pathology, since this procedure allows clinicians to avoid using the technically demanding transoral approach in which some or all of the odontoid tip is invisible...
March 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29289915/-congenital-anomalies-of-craniovertebral-junction-presenting-after-50-years-of-age-an-oxymoron-or-an-unusual-variation
#15
Pravin Salunke, Madhivanan Karthigeyan, Narasimhaiah Sunil, Vasundhara Rangan
OBJECTIVES: Manifestation of congenital anomalies of cranio-vertebral junction (CVJ) in the later half of life is unusual and intriguing. Coexisting cervical spondylotic changes with multilevel compression, poorer bone quality as well as less smooth post-surgical recuperation make management of elderly Congenital Atlantoaxial Dislocation/ Basilar Invagination (CAAD/BI) challenging. The clinico-radiological presentation, pathogenesis and outcome are analysed here. PATIENTS AND METHODS: Clinico-radiological data of 20 patients of CAAD/BI (with markers of congenital anomalies) presenting after 50 years of age, the challenges faced and outcomes after C1-C2 fusion have been analysed...
February 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29288330/evaluation-of-vertebral-artery-anomaly-in-basilar-invagination-and-prevention-of-vascular-injury-during-surgical-intervention-cta-features-and-analysis
#16
Shuaishuai Xu, Shidong Ruan, Xiaoyu Song, Jinyu Yu, Jianrong Xu, Ruozhen Gong
OBJECTIVE: To evaluate vertebral artery anomaly at the craniovertebral junction (CVJ) in patients with basilar invagination (BI) by computed tomographic angiography (CTA), and to discuss the prevention strategy of vascular injury. METHODS: The primary axial, multiple planar reconstruction and volume-rendering cervicocranial CTA images of 39 BI patients were analysed to evaluate vertebral artery anomaly at the CVJ: persistent first intersegmental artery (PFIA), fenestrated vertebral artery (FEN), and extracranial C1/2 origin of posterior inferior cerebellar artery (PICA), high-riding vertebral artery, side-to-side asymmetry and irregular midline carotid artery loop was determined by subjective vision...
December 29, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29285106/pediatric-chiari-malformation-type-i-long-term-outcomes-following-small-bone-window-posterior-fossa-decompression-with-autologous-fascia-duraplasty
#17
Hai Liu, Chenlong Yang, Jun Yang, Yulun Xu
Chiari malformation type I (CM-I) is a common hindbrain disorder that is associated with deformity and elongation of the cerebellar tonsils. Although CM-I occurs in both pediatric and adult patients, its prevalence, clinical features and management in the pediatric population are not well defined. The current study evaluated a consecutive case series of 92 children (38 females and 54 males) who were diagnosed with congenital CM-I. All patients underwent small-bone-window posterior fossa decompression with autologous-fascia duraplasty...
December 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29248777/atlantoaxial-joint-distraction-for-the-treatment-of-basilar-invagination-clinical-outcomes-and-radiographic-evaluation
#18
Sibin Lan, Junjie Xu, Zenghui Wu, Hong Xia, Xiangyang Ma, Kai Zhang, Fuzhi Ai, Jianhua Wang, Qingshui Yin, Honglei Yi, Mingyang Duan
OBJECTIVE: To investigate the causes of partial remission in patients with basilar invagination (BI) and irreducible atlantoaxial dislocation (IAAD) treated with transoral atlantoaxial reduction plate (TARP) without odontoidectomy and quantify the distance of odontoid descent. METHODS: Between August 2010 and July 2012, 22 consecutive patients with BI with IAAD who underwent TARP surgery were reviewed. The preoperative and postoperative radiographic parameters were evaluated...
March 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29242787/foot-deformities-in-hajdu-cheney-syndrome-a-rare-case-report-and-review-of-the-literature
#19
Ashish B Shah, Breann K Tisano, Osama Elattar, Jackson Rucker Staggers, Sameer Naranje
Introduction: Hajdu-Cheney syndrome (HCS) is a rare autosomal dominant disease characterized by acroosteolysis, wormian skull bones with persistent skull sutures, premature loss of teeth, micrognathia, short stature, hypermobility of the joints, neurologic manifestations such as basilar invagination with subsequent paresthesia, hearing loss, and speech alterations, and osteoporosis with tendency to pathologic fractures of long bones and vertebrae as well as painful hands and feet. Very few cases have been earlier reported in the literature...
September 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29235091/upward-displacement-of-the-odontoid-process-into-the-foramen-magnum-a-paleopathological-case
#20
Paola Saccheri, Enrico Crivellato, Francesco Toso, Luciana Travan
An upward displacement of the odontoid process into the foramen magnum was observed in the skeletal remains of a young male unearthed from a 14th-17th century cemetery in the north-eastern Italy. Examination of skull bone vestiges and CT-SCAN analysis of the axis exhibited a clear-cut contact zone between the odontoid process and the anterior border of the foramen magnum. In addition, the odontoid process appeared backward deviated. Findings suggest a possible diagnosis of basilar impression/invagination. This anomalous contact may cause compression of neural and vascular structures with a multifaceted series of clinical symptoms...
December 13, 2017: Folia Morphologica (Warsz)
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