Document Detail


Basilar invagination.
MedLine Citation:
PMID:  20173526     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Basilar invagination is a developmental anomaly of the craniovertebral junction in which the odontoid abnormally prolapses into the foramen magnum. It is often associated with other osseous anomalies of the craniovertebral junction, including atlanto-occipital assimilation, incomplete ring of C1, and hypoplasia of the basiocciput, occipital condyles, and atlas. Basilar invagination is also associated with neural axis abnormalities, including Chiari malformation, syringomyelia, syringobulbia, and hydrocephalus. Patients frequently present with neurologic symptoms and deficits and warrant surgical treatment to prevent progression. OBJECTIVE: To review the management of basilar invagination. METHODS: The literature was reviewed in reference to the evaluation and management of basilar invagination, with particular emphasis on the surgical treatment. RESULTS: Reducible basilar invagination may be treated with posterior decompression and stabilization. Ventral decompression may be necessary for basilar invagination with neural compression that is not reducible with axial cervical traction. Posterior cervical stabilization is necessary after ventral decompression. Modern rod and screw systems combined with autogenous bone graft enable correction of deformity, immediate stabilization, and high fusion rates. CONCLUSION: Basilar invagination is a developmental anomaly and commonly presents with neurologic findings. Treatment is typically surgical and involves anterior decompression followed by posterior stabilization for irreducible invagination and posterior decompression and stabilization for reducible invagination.
Authors:
Justin S Smith; Christopher I Shaffrey; Mark F Abel; Arnold H Menezes
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Neurosurgery     Volume:  66     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-22     Completed Date:  2010-06-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  39-47     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, University of Virginia, Charlottesville, Virginia 22908, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Arnold-Chiari Malformation / pathology,  physiopathology,  surgery
Bone Transplantation / methods,  trends
Brain Stem / abnormalities,  pathology,  physiopathology
Child, Preschool
Craniofacial Abnormalities / pathology,  physiopathology,  surgery*
Decompression, Surgical / instrumentation,  methods*
Female
Humans
Internal Fixators / standards,  trends
Male
Occipital Bone / abnormalities*,  pathology,  surgery*
Odontoid Process / abnormalities*,  pathology,  surgery*
Spinal Fusion / instrumentation,  methods*
Syringomyelia / pathology,  physiopathology,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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