Background:
Basilar invagination (BI) is a common malformation of the craniocervical region where the odontoid process protrudes into the foramen magnum. Surgery in this region is difficult because of the complex anatomy of the craniocervical junction. Serious life-threatening complications have been observed with previously described approaches. Therefore, we conceived a novel surgical approach that can be implemented by neurosurgeons with different skill levels to facilitate better outcomes.
Methods:
We describe a new surgical technique for the treatment of BI that we used in two patients in whom cervical myelopathy and direct ventral compression of the cervicomedullary junction were confirmed through clinical and radiological findings. We present the technique of posterior odontoidectomy in a step-by-step, didactic, and practical manner with surgical tips and tricks.
Results:
The resection was completed without intraoperative or postoperative complications in both cases. The patients experienced substantial neurological improvements, and full recovery was observed during the 9-month and 12-month follow-up visits after discharge. Compared with the transoral approach, our technique provides a larger decompression area.
Conclusions:
We describe a novel method for the treatment of BI that was applied in two patients and suggest that the posterior approach might be a safe and effective method for ventral decompression of the craniocervical junction. Posterior odontoidectomy followed by craniocervical fixation helped achieve complete cervicomedullary decompression.
Retroclival epidural hematoma in adults is uncommon. Although most cases are associated with craniocervical trauma, other mechanisms have been reported, such as coagulopathy, vascular lesions, and pituitary apoplexy. We report two adults diagnosed with retroclival epidural hematoma. One patient was an 89-year-old male with leukemia and thrombocytopenia who sustained a fall and developed a traumatic retroclival epidural hematoma with brainstem compression; surgery could not be performed due to his clinical condition and he died 5 days later. The other patient was a 78-year-old female with atrial fibrillation who developed a spontaneous retroclival epidural hematoma as a result of warfarin use; she was treated conservatively with anticoagulant reversal and methylprednisolone and was subsequently discharged without neurological deficit. Retroclival hematomas are primarily treated conservatively due to the difficulty of surgical approach. The bleeding mechanism and dural and venous anatomy of this region tend to limit hematoma expansion.
Soil erosion, mainly occurring in agricultural areas, is an economic and ecological problem that can happen anywhere. Swelling and transport of soil particles reduce the productivity of agricultural lands. Soil surface analysis and soil-water interaction are essential topics in agricultural research and engineering as they affect the risk of soil erosion. Erosion affects the upper soil layers rich in organic matter. After the transport of this topsoil, the subsoil with a more compact structure emerges. In this case, the cultivation of the soil becomes complex, and agricultural productivity is adversely affected. Different techniques have been used to analyze the effects of erosion. In this study, we focused on rill erosion, one of the types. An electronic imaging system has been designed using the Microsoft Kinect Sensor and Raspberry Pi, which can be found quickly and at a low cost during operation. The software has been developed to extract the surface topography by analyzing the depth images of rill erosion obtained with this system. Measurements were taken using eight types of flow rates on four soil types. As a result of the experimental findings, it has been seen that volume changes of 1.3812 mm3 can be detected as a unit with the Kinect Sensor placed at a distance of 70 cm.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.