Dynamic MRI was able to detect cases of cord compression that were not seen in neutral position and was diagnostic in all cases of mobile AAI where mobility at this joint affects the treatment options. Dynamic MRI is extremely useful for evaluating craniovertebral junction abnormalities and, in particular, cord compression.
Twelve patients with lesions in the anterior or anterolateral regions of foramen magnum were treated through the far lateral approach. The patients presented with neck pain, dysesthesia, quadriparesis, numbness, respiratory distress, and spastic contractures. Most lesions were meningiomas and neurofibromas, with one patient each with a posterior inferior cerebellar artery aneurysm, neurenteric cyst, and chordoma. All mass lesions were excised totally and the aneurysm was clipped. Three patients had severe respiratory problems preoperatively and two of them died. The other patients made a satisfactory neurological recovery. It was not found necessary to resect the condyle or mobilize the vertebral artery in any of the patients.
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