A minimally invasive endoscopic transnasal approach to the craniovertebral junction in the paediatric population.

Abstract

A 13-year-old male with Type 1 Chiari malformation presented with progressive limb weakness for 2 months. He had a high stepping, unsteady gait with grade 4/5 motor strength in all extremities and increased reflexes. Computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated Arnold–Chiari malformation type I with basilar invagination, worsening syringomyelia and tonsillar herniation (Fig. 1a). There was no evidence of hydrocephalus. He underwent an occipitocervical instrumentation and fusion followed by endoscopic transnasal odontoidectomy in the same operative setting.