Reconsideration of the transoral odontoidectomy in complex craniovertebral junction patients with irreducible anterior compression
Reconsideration of the transoral odontoidectomy in complex craniovertebral junction patients with irreducible anterior compression作者机构：Department of Neurological Surgery Xuanwu Hospital Capital Medical University Beijing 100053 China
出 版 物：《中华神经外科杂志(英文)》 (Chinese Neurosurgical Journal)
年 卷 期：2021年第6卷第1期
页 面：28-35页
核心收录：
学科分类：1002[医学-临床医学] 1001[医学-基础医学(可授医学、理学学位)] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 1009[医学-特种医学] 10[医学]
基 金：This work was supported by a grant of the Beijing Board of Science and Technology(Z191199996619048)
主 题：Transoral approach Odontoidectomy Basilar invagination Atlantoaxial dislocation Image-guided navigation
摘 要：Background: Although the single-stage posterior realignment craniovertebral junction (CVJ) surgery could treat most of the basilar invagination (BI) and atlantoaxial dislocation (AAD), there are still some cases with incomplete decompression of the spinal cord, which remains a technique challenging ***: Eleven patients were included with remained myelopathic symptoms after posterior correction due to incomplete decompression of the spinal cord. Transoral odontoidectomy assisted by image-guided navigation and intraoperative CT was performed. Clinical assessment and image measurements were performed preoperatively and at the most recent ***: Eleven patients were followed up for an average of 47 months. Symptoms were alleviated in 10 of 11 patients (90.9%). One patient died of an unknown reason 1 week after the transoral approach. The clinical and radiological parameters pre- and postoperatively were ***: Transoral odontoidectomy as a salvage surgery is safe and effective for properly selected BI and AAD patients after inadequate indirect decompression from posterior distraction and fixation. Image-guided navigation and intraoperative CT can provide precise information and accurate localization during operation, thus enabling complete resection of the odontoid process and decompression of the spinal cord.
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