The simple posterior operation for different types of malformations in the craniocervical junction with atlantoaxial dislocation

Abstract

Objective: To explore the therapeutic effect of simple posterior reduction and decompression technique for different types of malformations in the craniocervical junction with atlantoaxial dislocation. Methods: The clinical data of 34 cases of different malformations in the craniocervical junction who were treated by the simple posterior internal fixation and decompression surgery in the department of neurosurgery of the first affiliated hospital of Nanchang University from March 2014 to March 2017 were analyzed retrospectively.In 34 cases, including 26 cases of basilar invagination with atlantoaxial dislocation (19 cases with atlanto occipital fusion, 12 cases with Chiari malformation, 13 cases with syringomyelia), 8 cases of odontoid malformation with atlantoaxial dislocation (2 cases with Chiari malformation, 1 case with flat skull base, 1 case with malformation of atlas). All the cases were performed Dynamic position X-ray film, CT scan and Three-dimensional reconstruction, and craniocervical MRI scan before the operation.The enlarged decompression of the occipital foramen, the fixation and fusion of the occipitocervical were performed during the operation, and the patients with cerebellar tonsillar hernia were performed decompression of the occipital small bone window. Results: All patients were followed up after the operation.The symptoms were obviously improved in 29 cases (85.3%), stability and no change in 5 cases (14.7%) and none postoperative neurological deterioration cases. Conclusion: The treatment of craniocervical junction malformation using simple posterior reduction and decompression technique is effective and has few complications, which can obviously improve the life quality of the patients.