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Journal of Korean Neurosurgical Society > Volume 50(6); 2011 > Article
Journal of Korean Neurosurgical Society 2011;50(6): 528-531.
doi: https://doi.org/10.3340/jkns.2011.50.6.528
Vertical Reduction Using Atlantoaxial Facet Spacer in Basilar Invagination with Atlantoaxial Instability.
Il Sup Kim, Jae Taek Hong, Jae Hoon Sung, Jae Hoon Byun
Department of Neurosurgery, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea. jatagi15@paran.com
Although posterior segmental fixation technique is becoming increasingly popular, surgical treatment of craniovertebral junctional disorders is still challenging because of its complex anatomy and surrounding critical neurovascular structures. Basilar invagination is major pathology of craniovertebral junction that has been a subject of clinical interest because of its various clinical presentations and difficulty of treatment. Most authors recommend a posterior occipitocervical fixation following transoral decompression or posterior decompression and occipitocervical fixation. However, both surgical modalities inadvertently sacrifice C0-1 and C1-2 joint motion. We report two cases of basilar invagination reduced by the vertical distraction between C1-2 facet joint. We reduced the C1-2 joint in an anatomical position and fused the joint with iliac bone graft and C1-2 segmental fixation using the polyaxial screws and rods C-1 lateral mass and the C-2 pedicle.
Key Words: Atlantoaxial instability; Basilar invagination; Vertical reduction
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