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Basilar decompression via a far lateral transcondylar approach: technical note.
Rennert, Robert C; Stephens, Marcus L; Palmer, Angela W; Rodriguez, Analiz; Kazemi, Noojan; Morris, Thomas W; Pait, T Glen; Day, J D.
Afiliación
  • Rennert RC; Department of Neurological Surgery, University of California San Diego, San Diego, CA, USA.
  • Stephens ML; Department of Neurological Surgery, University of Arkansas, Little Rock, AR, USA.
  • Palmer AW; Department of Neurological Surgery, University of Arkansas, Little Rock, AR, USA.
  • Rodriguez A; Department of Neurological Surgery, University of Arkansas, Little Rock, AR, USA.
  • Kazemi N; Department of Neurological Surgery, University of Arkansas, Little Rock, AR, USA.
  • Morris TW; Department of Neurological Surgery, University of Arkansas, Little Rock, AR, USA.
  • Pait TG; Department of Neurological Surgery, University of Arkansas, Little Rock, AR, USA.
  • Day JD; Department of Neurological Surgery, University of Arkansas, Little Rock, AR, USA. JDDay@uams.edu.
Acta Neurochir (Wien) ; 164(10): 2563-2572, 2022 10.
Article en En | MEDLINE | ID: mdl-35867183
BACKGROUND: Treatments for symptomatic or unstable basilar invagination (BI) include posterior decompression, distraction/fusion, trans-nasal or trans-oral anterior decompression, and combined techniques, with the need for occipitocervical fusion based on the degree of craniocervical instability. Variations of the far lateral transcondylar approach are described in limited case series for BI, but have not been widely applied. METHODS: A single-institution, retrospective review of consecutive patients undergoing a far lateral transcondylar approach for odontoidectomy (± resection of the inferior clivus) followed by occipitocervical fusion over a 6-year period (1/1/2016 to 12/31/2021) is performed. Detailed technical notes are combined with images from cadaveric dissections and patient surgeries to illustrate our technique using a lateral retroauricular incision. RESULTS: Nine patients were identified (3 males, 6 females; mean age 40.2 ± 19.6 years). All patients had congenital or acquired BI causing neurologic deficits. There were no major neurologic or wound-healing complications. 9/9 patients (100%) experienced improvement in preoperative symptoms. CONCLUSIONS: The far lateral transcondylar approach provides a direct corridor for ventral brainstem decompression in patients with symptomatic BI. A comprehensive knowledge of craniovertebral junction anatomy is critical to the safe performance of this surgery, especially when using a lateral retroauricular incision.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Platibasia / Fusión Vertebral Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Acta Neurochir (Wien) Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Austria
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Platibasia / Fusión Vertebral Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Acta Neurochir (Wien) Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Austria