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Endoscopic transnasal odontoid resection to decompress the bulbo-medullary junction: a reliable anterior minimally invasive technique without posterior fusion.
Eur Spine J. 2012 May; 21 Suppl 1:S55-60.ES

Abstract

PURPOSE

Anterior decompression of the craniovertebral junction is reserved to patients with irreducible ventral bulbo-medullary lesions and rapidly deteriorating neurological functions. Classically performed through the transoral approach, the exposure of this region can be now achieved by a minimally invasive endonasal endoscopic approach (EEA).

METHODS

Four patients with irreducible, anterior bulbo-medullary compression due to rheumatoid pannus and basilar invagination were enrolled. The imaged-guided EEA was used to resect the odontoid process, trying to preserve the C1 anterior arch.

RESULTS

Neurological improvement and adequate bulbo-medullary decompression were obtained in all patients. In two cases, anterior C1 ring was preserved. These patients did not required a posterior fusion.

CONCLUSIONS

Compared with the standard transoral technique, the EEA provides the same good exposure but with potentially less complications. The preservation of the anterior C1 arch can contribute to avoid cranial settling and posterior fusion with its related risk of subaxial instability.

Authors+Show Affiliations

Department of Neurosurgery, Umberto I University General Hospital, Università Politecnica delle Marche, Ancona, Italy. mauriziogladi@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

22398642

Citation

Gladi, Maurizio, et al. "Endoscopic Transnasal Odontoid Resection to Decompress the Bulbo-medullary Junction: a Reliable Anterior Minimally Invasive Technique Without Posterior Fusion." 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, vol. 21 Suppl 1, 2012, pp. S55-60.
Gladi M, Iacoangeli M, Specchia N, et al. Endoscopic transnasal odontoid resection to decompress the bulbo-medullary junction: a reliable anterior minimally invasive technique without posterior fusion. Eur Spine J. 2012;21 Suppl 1:S55-60.
Gladi, M., Iacoangeli, M., Specchia, N., Re, M., Dobran, M., Alvaro, L., Moriconi, E., & Scerrati, M. (2012). Endoscopic transnasal odontoid resection to decompress the bulbo-medullary junction: a reliable anterior minimally invasive technique without posterior fusion. 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, 21 Suppl 1, S55-60. https://doi.org/10.1007/s00586-012-2220-4
Gladi M, et al. Endoscopic Transnasal Odontoid Resection to Decompress the Bulbo-medullary Junction: a Reliable Anterior Minimally Invasive Technique Without Posterior Fusion. Eur Spine J. 2012;21 Suppl 1:S55-60. PubMed PMID: 22398642.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopic transnasal odontoid resection to decompress the bulbo-medullary junction: a reliable anterior minimally invasive technique without posterior fusion. AU - Gladi,Maurizio, AU - Iacoangeli,Maurizio, AU - Specchia,Nicola, AU - Re,Massimo, AU - Dobran,Mauro, AU - Alvaro,Lorenzo, AU - Moriconi,Elisa, AU - Scerrati,Massimo, Y1 - 2012/03/08/ PY - 2012/02/14/received PY - 2012/02/19/accepted PY - 2012/3/9/entrez PY - 2012/3/9/pubmed PY - 2012/11/7/medline SP - S55 EP - 60 JF - 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 JO - Eur Spine J VL - 21 Suppl 1 N2 - PURPOSE: Anterior decompression of the craniovertebral junction is reserved to patients with irreducible ventral bulbo-medullary lesions and rapidly deteriorating neurological functions. Classically performed through the transoral approach, the exposure of this region can be now achieved by a minimally invasive endonasal endoscopic approach (EEA). METHODS: Four patients with irreducible, anterior bulbo-medullary compression due to rheumatoid pannus and basilar invagination were enrolled. The imaged-guided EEA was used to resect the odontoid process, trying to preserve the C1 anterior arch. RESULTS: Neurological improvement and adequate bulbo-medullary decompression were obtained in all patients. In two cases, anterior C1 ring was preserved. These patients did not required a posterior fusion. CONCLUSIONS: Compared with the standard transoral technique, the EEA provides the same good exposure but with potentially less complications. The preservation of the anterior C1 arch can contribute to avoid cranial settling and posterior fusion with its related risk of subaxial instability. SN - 1432-0932 UR - https://www.unboundmedicine.com/medline/citation/22398642/Endoscopic_transnasal_odontoid_resection_to_decompress_the_bulbo_medullary_junction:_a_reliable_anterior_minimally_invasive_technique_without_posterior_fusion_ L2 - https://doi.org/10.1007/s00586-012-2220-4 DB - PRIME DP - Unbound Medicine ER -