Management of congenital craniovertebral anomalies: a single-centre experience of 71 cases by an algorithmic approach.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
Sudhir K SrivastavaManojkumar Gaddikeri

Abstract

Retrospective study. Congenital craniovertebral (CV) anomalies include a wide variety of conditions involving basilar invagination (BI), atlantoaxial dislocation (AAD), bony congenital anomalies and Chiari malformation. The management of these disorders is more surgeon dependent rather than based on clear guidelines. This study aims to provide a step-by-step algorithmic approach to the management of congenital CV anomalies to achieve good CV alignment, neural recovery and long lasting stability. The study retrospectively analyses 71 patients of congenital CV anomalies treated by our algorithmic approach. Clinical assessment was done with the help of Nurick's grading pre- and post-operatively. Radiological outcome was assessed by plain radiographs, and computed tomographic scan was done at 12-month follow-up. Mean age at presentation was 17.9 years (6-41 years). Mean Nurick score pre-operatively was 3.8 which was reduced to 1.3 at a mean follow-up of 13.6 months. Sixty-one patients had type I BI, 6 had type II BI, and 4 patients had os odontoideum. Most common symptom at presentation was weakness in limbs, neck pain and difficulty in walking. Patients of isolated AAD with os odontoideum required posterior atlantoaxial fixation a...Continue Reading

References

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Apr 5, 2008·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Raheel AhmedArnold H Menezes
Mar 5, 2010·Neurosurgery·Wesley HsuDaniel M Sciubba
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Mar 13, 2012·Neurology India·Vijendra K Jain
May 4, 2013·Neurosurgical Review·Ricardo Vieira Botelho, Edson Dener Zandonadi Ferreira

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