Treatment of Craniocervical Spine Lesion With Osteogenesis Imperfecta

Nakamura, Masahiro; Yone, Kazunori; Yamaura, Ichiro; Ryoki, Yoshihiro; Okano, Natsuko; Higo, Masaru; Komiya, Setsuro

doi:10.1097/00007632-200204150-00025

Cited by 14 publications

(5 citation statements)

References 20 publications

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“…They may have megalocephaly, macroglossia, cranio-vertebral junction problems including atlanto-axial subluxation and short neck contributing to a difficult airway. [45]…”

Section: Discussionmentioning

confidence: 99%

A rare occurrence of pyloric stenosis in an infant with osteogenesis imperfecta: Anesthetic implications

Jagtap¹,

Bakhshi²,

Jain³

2014

J Anaesthesiol Clin Pharmacol

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Congenital anomalies pose many challenges during anesthesia due to anatomic and physiological alterations. The inherent complications associated with the disorders necessitate vigilance for providing anesthesia to even seemingly simple surgical intervention. Here, we share our experience of anesthesia management of an infant of congenital osteogenesis imperfecta with pyloric stenosis for pyloromyotomy.

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“…They may have megalocephaly, macroglossia, cranio-vertebral junction problems including atlanto-axial subluxation and short neck contributing to a difficult airway. [45]…”

Section: Discussionmentioning

confidence: 99%

A rare occurrence of pyloric stenosis in an infant with osteogenesis imperfecta: Anesthetic implications

Jagtap¹,

Bakhshi²,

Jain³

2014

J Anaesthesiol Clin Pharmacol

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“…There is a report of a patient with OI and BI associated with syringomyelia who underwent posterior fusion without posterior fossa decompression and had a good postoperative course [6]. In contrast, Noske et al [7] reported that a patient who underwent Halo traction and achieved improvement in symptoms, and then underwent posterior decompression and fusion, showed improvement for 2 years, but hydrocephalus and other symptoms then worsened and VP shunting was required.…”

Section: Discussionmentioning

confidence: 99%

“…OI has previously been associated with basilar impression (BI) [4,5]. However, OI is relatively rare (1/20,000-30,000) and there are many asymptomatic cases; thus, there are few case reports of surgery for OI and optimal operative procedures have not been defined [5][6][7]. A combination of anterior and posterior surgery with ventriculoperitoneal (VP) shunting has been proposed to be required [5], but it is unclear if such a major operation is needed for all cases of OI with BI.…”

Section: Introductionmentioning

confidence: 99%

Factors related to surgical outcome after posterior decompression and fusion for craniocervical junction lesions associated with osteogenesis imperfecta

et al. 2011

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Treatment for craniocervical junction lesions associated with osteogenesis imperfecta (OI) has been described, but there are divergent views on operative procedures and preoperative and postoperative therapies due to the small number of cases. It has been suggested that a major procedure such as combined anterior and posterior surgery with concomitant ventriculoperitoneal (VP) shunting is required for OI associated with basilar impression (BI). However, here we report a case with a good outcome after posterior decompression fusion only. The patient was a 29-year-old woman with OI (Sillence type-IA) who had neurological symptoms of vertigo, nausea, and shaking during walking. Diagnostic imaging revealed hydrocephalus, severe BI, and Chiari type-II malformation. Preoperative Halo traction led to improvement in symptoms, and posterior decompression fusion from the occipital bone to C6 was subsequently performed. Lateral mass screws and Nesplon cables as sublaminar wiring for reinforcement for fusion were used in the operation. The patient wore a Halo vest for 4 weeks postoperatively. She experienced no symptoms postoperatively. Bone fusion and improved hydrocephalus were clear on images at 3 years after surgery, and the postoperative course has been good. In craniocervical junction lesions associated with OI, instability with compression of the nerve and bone fragility in multiple sites can become problematic. Anterior odontoid resection and posterior fusion are required for OI with BI to give ideal decompression on images. However, the results of this case suggest that a good postoperative outcome can be achieved by performing not the combination of anterior odontoid resection and VP shunting, but only with posterior decompression fusion, especially for OI cases of Sillence type-I.

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“…45,49 With the current rigid cervical spine instrumentation an all posterior occipitocervical spinal fusion and decompression with preoperative HALO traction and/or ventriculoperitoneal shunting has resulted in resolution of neurological symptoms. 44,47,50,51 To reduce risk of nonunion it is the authors’ practice to halt BP treatment for four months postoperatively and use a structural rib grafting to span the instrumentation.…”

Section: Essentials Of the Cervical Spinementioning

confidence: 99%

Complex spine deformities in young patients with severe osteogenesis imperfecta: Current concepts review

Castelein

Hasler

Helenius

et al. 2019

Journal of Children's Orthopaedics

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The severity of osteogenesis imperfecta (OI), the associated reduced quality and quantity of collagen type I, the degree of bone fragility, ligamentous laxity, vertebral fractures and multilevel vertebral deformities all impair the mechanical integrity of the whole spinal architecture and relate to the high prevalence of progressive kyphoscoliotic deformities during growth. Bisphosphonate therapy may at best slow down curve progression but does not seem to lower the prevalence of deformities or the incidence of surgery. Brace treatment is problematic due to pre-existing chest wall deformities, stiffness of the curve and the brittleness of the ribs which limit transfer of corrective forces from the brace shell to the spine. Progressive curves entail loss of balance, chest deformities, pain and compromise of pulmonary function and eventually require surgical stabilization, usually around puberty. Severe vertebral deformities including deformed, small pedicles, highly brittle bones and chest deformities, short deformed trunks and associated issues like C-spine and cranial base abnormalities (basilar impressions, cervical kyphosis) as well as deformed lower and upper extremities are posing multiple peri- and intraoperative challenges. Hence, an early multidisciplinary approach (anaesthetist, pulmonologist, paediatric orthopaedic spine surgeon) is mandatory. This paper was written under the guidance of the Spine Study Group of the European Paediatric Orthopaedic Society. It highlights the most pertinent information given in the current literature and various practical aspects on surgical care of spine deformities in young OI patients based on the personal experience of the contributing authors.

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Treatment of Craniocervical Spine Lesion With Osteogenesis Imperfecta

Cited by 14 publications

References 20 publications

A rare occurrence of pyloric stenosis in an infant with osteogenesis imperfecta: Anesthetic implications

A rare occurrence of pyloric stenosis in an infant with osteogenesis imperfecta: Anesthetic implications

Factors related to surgical outcome after posterior decompression and fusion for craniocervical junction lesions associated with osteogenesis imperfecta

Complex spine deformities in young patients with severe osteogenesis imperfecta: Current concepts review

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