Realignment of Basilar Invagination by C1-C2 Joint Distraction: A Modified Approach to a Paradigm Shift. View Full Text


Ontology type: schema:Chapter     


Chapter Info

DATE

2019

AUTHORS

Francesco Cacciola , Bronek Boszczyk , Paolo Perrini , Pasquale Gallina , Nicola Di Lorenzo

ABSTRACT

BACKGROUND: Distraction of the C1-C2 joint and maintenance thereof by introduction of spacers into the articular cavity can successfully and durably reduce basilar invagination (BI). Thus, with the adjunct of instrumented fusion and decompression, BI-induced myelopathy can be efficiently treated with a one-stage posterior approach. This intervention is technically challenging, and in this paper we describe a procedural variation to facilitate the approach. METHODS AND RESULTS: Through a description of a case of BI, the main anatomopathological alteration underlying and perpetrating the condition of BI is elucidated. A technique of realignment of BI is then described in which this alteration is specifically targeted and neutralized. The result is a single-stage posterior-only approach with decompression, C1-C2 distraction and introduction of poly(methyl methacrylate) (PMMA) into the joint cavity. Instrumented occipitocervical fusion completes the procedure. CONCLUSION: C1-C2 joint distraction is a technically demanding procedure. By providing a modification of the original technique and a detailed description of the crucial steps necessary to successfully and safely carry it out, we hope to make this excellent procedure more approachable. More... »

PAGES

273-277

Book

TITLE

New Trends in Craniovertebral Junction Surgery

ISBN

978-3-319-62514-0
978-3-319-62515-7

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/978-3-319-62515-7_39

DOI

http://dx.doi.org/10.1007/978-3-319-62515-7_39

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1111099632

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30610333


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