Abstract
BackgroundAlthough the single-stage posterior realignment craniovertebral junction (CVJ) surgery could treat most of the basilar invagination (BI) and atlantoaxial dislocation (AAD), there are still some cases with incomplete decompression of the spinal cord, which remains a technique challenging situation.MethodsEleven patients were included with remained myelopathic symptoms after posterior correction due to incomplete decompression of the spinal cord. Transoral odontoidectomy assisted by image-guided navigation and intraoperative CT was performed. Clinical assessment and image measurements were performed preoperatively and at the most recent follow-up.ResultsEleven patients were followed up for an average of 47 months. Symptoms were alleviated in 10 of 11 patients (90.9%). One patient died of an unknown reason 1 week after the transoral approach. The clinical and radiological parameters pre- and postoperatively were reported.ConclusionTransoral odontoidectomy as a salvage surgery is safe and effective for properly selected BI and AAD patients after inadequate indirect decompression from posterior distraction and fixation. Image-guided navigation and intraoperative CT can provide precise information and accurate localization during operation, thus enabling complete resection of the odontoid process and decompression of the spinal cord.
Highlights
The single-stage posterior realignment craniovertebral junction (CVJ) surgery could treat most of the basilar invagination (BI) and atlantoaxial dislocation (AAD), there are still some cases with incomplete decompression of the spinal cord, which remains a technique challenging situation
Basilar invagination (BI) is the most common congenital malformation of the craniovertebral junction (CVJ), and it is characterized by protrusion of the odontoid process into the foramen magnum leading to ventral compression of the spinal cord [1,2,3,4,5]
Single-stage posterior realignment CVJ surgery to treat BI with AAD has been widely accepted as first-line treatment for this pathological entity, usually obviating the need for a transoral odontoidectomy
Summary
The single-stage posterior realignment craniovertebral junction (CVJ) surgery could treat most of the basilar invagination (BI) and atlantoaxial dislocation (AAD), there are still some cases with incomplete decompression of the spinal cord, which remains a technique challenging situation. Basilar invagination (BI) is the most common congenital malformation of the craniovertebral junction (CVJ), and it is characterized by protrusion of the odontoid process into the foramen magnum leading to ventral compression of the spinal cord [1,2,3,4,5]. Single-stage posterior realignment CVJ surgery to treat BI with AAD has been widely accepted as first-line treatment for this pathological entity, usually obviating the need for a transoral odontoidectomy. A small proportion of patients continue to have persistent myelopathy because of
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
