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Reconsideration of the transoral odontoidectomy in complex craniovertebral junction patients with irreducible anterior compression

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中华神经外科杂志(英文) 2021年第1期6卷 28-35页

作者： Wang Xingwen Ma Longbing Liu Zhenlei Chen Zan Wu Hao Jian Fengzeng Department of Neurological Surgery Xuanwu Hospital Capital Medical University Beijing 100053 China

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.

关键词： Transoral approach Odontoidectomy Basilar invagination Atlantoaxial dislocation image-guided navigation

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