Transoral Decompression and Anterior Stabilization of Atlantoaxial Joint in Patients with Basilar Impression and Chiari Malformation Type I: A Technical Report of 2 Clinical Cases.

OBJECTIVE: Presentation of clinical cases involving successful anterior stabilization of the C1-C2 segment in patients with invaginated C2 odontoid process and Chiari malformation type I.

METHODS: Clinical case description.

RESULTS: Two patients with C2 odontoid processes invagination and Chiari malformation type I were surgically treated using the transoral approach. In both cases, anterior decompression of the upper cervical region was performed, followed by anterior stabilization of the C1-C2 segment. In 1 of the cases, this procedure was performed after posterior decompression, which led to transient regression of neurologic symptoms. In both cases, custom-made cervical plates were used for anterior stabilization of the C1-C2 segment. During the follow-up period of more than 2 years, a persistent regression of both the neurologic symptoms and Chiari malformation was observed.

CONCLUSIONS: Anterior decompression followed by anterior stabilization of the C1-C2 segment is a novel and promising approach to treating Chiari malformation type I in association with C2 odontoid process invagination.