C1C2 Distraction and Compression Technique for Craniovertebral Junction Anomalies with Basilar Invagination and Irreducible Atlantoaxial Dislocation

Yerramneni, Vamsi Krishna; Kotha, V.; Reddy, Ramanadha

doi:10.1055/s-0038-1649333

Cited by 1 publication

(2 citation statements)

References 21 publications

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“…The authors have used a similar technique as Yerramneni et al [6] and have obtained a good outcome. The rotational asymmetry at the C1-C2 joint space was corrected using different sizes of spacers.…”

Section: Surgical Decision-making In Complex Chiari Malformationmentioning

confidence: 99%

See 1 more Smart Citation

Complex chiari malformation presenting with bulbar symptoms in an adult: Single-stage posterior fusion and foramen magnum decompression: A rare case report

Balasubramanian¹,

Saphiya²,

Madan³

et al. 2020

Asian J Neurosurg

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Complex Chiari malformation (CCM) is a spectrum of congenital bony and soft tissue abnormalities, which includes Chiari 1.5 malformation, medullary kinking, retroflexed odontoid, abnormal clival-cervical angle (CXA), occipitalization of the atlas, basilar invagination, syringomyelia, and scoliosis. CCM usually manifests in the pediatric age group and is a challenging entity to treat. It requires detailed evaluation of craniometric indices to decide the appropriate surgical management. Patients with maximum perpendicular distance of dens to the line from the basion to the inferoposterior part of the C2 body (pBC2 line) of more than 9 mm and CXA <125° require a posterior fixation and will benefit from a single-stage posterior fusion and foramen magnum decompression (FMD). We report a rare case of CCM manifesting in a 32-year-old male with brainstem compression and bulbar symptoms. We could realign the craniovertebral junction with only a C1-C2 fixation by a modified distraction, compression, extension, and reduction technique and also relieve the neural compression by FMD and tonsillar resection in a single surgery with a good outcome. The authors find it to be an effective alternative to avoid the occipital fixation.

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Section: Surgical Decision-making In Complex Chiari Malformationmentioning

confidence: 99%

“…They have got good results in all four cases and conclude that the combination of C1-C2 screw placement, followed by joint opening, spacer insertion, and subsequent distraction and compression at the screw heads has the potential to correct the alignment of the CVJ including the rotational component at the C1C2 Joints. [6]…”

Section: Treatment Optionsmentioning

confidence: 99%