Craniovertebral Junction Anomalies: Changing Paradigms, Shifting Perceptions: Where Are We and Where Are We Going?

Chandra, P. Sarat

doi:10.14245/ns.19edi.004

Cited by 4 publications

(3 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although the outcome has been reported as positive, this method of treatment has not been generally accepted yet as a standard mode of treatment for CID. 53 Brockmeyer et al reviewed the medical literature in 2011 and concluded that C1-C2 fixation is indicated in complex CID patients with basilar invagination (BI) associated with C1-C2 instability. 54,55 It also depends on the type of BI: type I requires instrumentation and fusion plus traction; in BI type II, fixation is recommended for selected cases, and some cases are to be decompressed only.…”

Section: Clinical Questions 1) What Is the Definition And Best Nomencmentioning

confidence: 99%

Management of Chiari I deformity in Children and Adolescents: A report from the Consensus Taskforce of the Brazilian Society of Pediatric Neurosurgery

Santos

Furlanetti

Canheu

et al. 2020

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

View full text Add to dashboard Cite

Much controversy remains on the current management of Chiari I deformity (CID) in children, with many clinical, surgical and ethic-legal implications. The Brazilian Society of Pediatric Neurosurgery (SBNPed, in the Portuguese acronym) has put together a panel of experts to analyze updated published data on the medical literature about this matter and come up with several recommendations for pediatric neurosurgeons and allied health professionals when dealing with CID. Their conclusions are reported herein, along with the respective scientific background.

show abstract

Section: Clinical Questions 1) What Is the Definition And Best Nomencmentioning

confidence: 99%

Management of Chiari I deformity in Children and Adolescents: A report from the Consensus Taskforce of the Brazilian Society of Pediatric Neurosurgery

Santos

Furlanetti

Canheu

et al. 2020

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

View full text Add to dashboard Cite

show abstract

“…More recently , Goel et al proposed that the tonsillar herniation in CM is a protective mechanism due to the subtle or gross instability which occurs in all cases and hence C1-C2 fixations are required for all patients with CMs. [4] While the question of whether all patients require C1-C2 fixation remains debated, the spectrum of patients with complex bony abnormalities and rotational asymmetry always need some sort of posterior fusion procedure to restore the CVJ alignment.…”

Section: Treatment Optionsmentioning

confidence: 99%

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

View full text Add to dashboard Cite

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.

show abstract

“…The quoted incidence in the literature varies in geographical and genetic backgrounds, and ranges from 4% to 5% in the pediatric population. [ 2 3 4 5 ] Surgical fixation and fusion are the preferred, and sometimes the only treatment option, for symptomatic patients. Nearly a dozen surgical approaches have been described and validated in the literature, but still the topic remains a conundrum or most controversial and debatable.…”

Section: Introductionmentioning

confidence: 99%

Does socioeconomic status have an association with cranio-vertebral anomalies: A step toward healing the curse!

et al. 2021

View full text Add to dashboard Cite

A BSTRACT Background: The etiological or causal factors of pediatric craniovertebral junction anomalies (CVJA) are still unknown. The disease bears a major proportion of economic and social burdens over a developing country like ours. This article aims to highlight an important modifiable factor that may prove to have a critical causal relationship with disease incidence. Materials and Methods: This is a cross-sectional, single-institutional study, wherein the socioeconomic status (SES) of all the operated pediatric patients of CVJA, between 2014 and 2019, was studied. Variables including the patient’s age, sex, residence status (rural or urban), perioperative data, length of stay, follow-up, and the time between revision surgery (if required) and clinical presentation were noted. Data regarding average household and type of family (nuclear or joint) were also enquired. Results: Sixty-six patients (M:F 56:10) with a mean age of 13.14 ± 3.44 years were included. The mean annual family income was 11.1 ± 12.1 thousands. 43.9% belonged to joint family; according to Kuppuswami and Prasad scale, 42.4% of patients belong to lower class, while 20 patients belong to lower middle class, and 14 patients belong to the below poverty line category. Neither the SES of patient nor rural–urban background affected the surgical outcome. The mean follow-up of patients in our study was 42.3 ± 23.0 months and 83.3% had a good outcome. Discussion: Patients operated for CVJ anomaly in the authors’ institution mainly come from the lower socioeconomic groups. The present study raises several important questions like nutritional deficiencies in reproductive age group females leading to a cascade of events as a causal factor.

show abstract

Craniovertebral Junction Anomalies: Changing Paradigms, Shifting Perceptions: Where Are We and Where Are We Going?

Cited by 4 publications

References 14 publications

Management of Chiari I deformity in Children and Adolescents: A report from the Consensus Taskforce of the Brazilian Society of Pediatric Neurosurgery

Management of Chiari I deformity in Children and Adolescents: A report from the Consensus Taskforce of the Brazilian Society of Pediatric Neurosurgery

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

Does socioeconomic status have an association with cranio-vertebral anomalies: A step toward healing the curse!

Contact Info

Product

Resources

About