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Surgical Management of Adult Reducible Atlantoaxial Dislocation, Basilar Invagination and Chiari Malformation with Syringomyelia.
Turk Neurosurg. 2016; 26(4):615-21.TN

Abstract

AIM

To analyze retrospectively the surgical management of reducible atlantoaxial dislocation (AAD), basilar invagination (BI) and Chiari malformation (CHM) with syringomyelia through a single-stage posterior approach.

MATERIAL AND METHODS

Forty-three patients with reducible AAD, BI and CHM with syringomyelia underwent surgery from January 2009 to January 2013. Intraoperative restoration followed by posterior decompression and plate-rod placement with occipital cortical screws and C2/C3 lateral mass cortical screws fixation devices were used in all patients. Results were recorded both pre- and postoperatively and these outcome measures included Nurick grading (NG) and radiology findings (atlantodental interval (ADI), space available for the spinal cord (SAC), interval between odontoid and Chamberlain's line (IOC), and the cervicomedullary angle (CMA)).

RESULTS

Forty (93%) of the 43 patients were followed up. Thirty-six (90%) patients' symptoms improved and four (10%) stabilized. No patients became progressively worse. The difference between preoperative and postoperative Nurick grades was statistically significant. All patients achieved restoration, including thirty (75%) patients had full restoration and ten (25%) had part restoration. The size of syringomyelia was obviously decreased in 32 (80%) patients and stable in 8 (20%) patients. All radiology findings (ADI, IOC, SAC, CMA) showed significant changes from pre- to postoperative (p < 0.01).

CONCLUSION

Intraoperative distraction, extension combined posterior decompression with use of plate-rod-screws occipitocervical fusion device is an effective method to treat AAD, BI and CHM with syringomyelia.

Authors+Show Affiliations

Sichuan University, West China Hospital, Department of Neurosurgery, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27400111

Citation

Shuhui, Gong, et al. "Surgical Management of Adult Reducible Atlantoaxial Dislocation, Basilar Invagination and Chiari Malformation With Syringomyelia." Turkish Neurosurgery, vol. 26, no. 4, 2016, pp. 615-21.
Shuhui G, Jiagang L, Haifeng C, et al. Surgical Management of Adult Reducible Atlantoaxial Dislocation, Basilar Invagination and Chiari Malformation with Syringomyelia. Turk Neurosurg. 2016;26(4):615-21.
Shuhui, G., Jiagang, L., Haifeng, C., Hao, Z. B., & Qing, H. S. (2016). Surgical Management of Adult Reducible Atlantoaxial Dislocation, Basilar Invagination and Chiari Malformation with Syringomyelia. Turkish Neurosurgery, 26(4), 615-21. https://doi.org/10.5137/1019-5149.JTN.13884-14.2
Shuhui G, et al. Surgical Management of Adult Reducible Atlantoaxial Dislocation, Basilar Invagination and Chiari Malformation With Syringomyelia. Turk Neurosurg. 2016;26(4):615-21. PubMed PMID: 27400111.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Surgical Management of Adult Reducible Atlantoaxial Dislocation, Basilar Invagination and Chiari Malformation with Syringomyelia. AU - Shuhui,Gong, AU - Jiagang,Liu, AU - Haifeng,Chen, AU - Hao,Zhao Bo, AU - Qing,Huang Si, PY - 2016/7/12/entrez PY - 2016/7/12/pubmed PY - 2016/12/15/medline SP - 615 EP - 21 JF - Turkish neurosurgery JO - Turk Neurosurg VL - 26 IS - 4 N2 - AIM: To analyze retrospectively the surgical management of reducible atlantoaxial dislocation (AAD), basilar invagination (BI) and Chiari malformation (CHM) with syringomyelia through a single-stage posterior approach. MATERIAL AND METHODS: Forty-three patients with reducible AAD, BI and CHM with syringomyelia underwent surgery from January 2009 to January 2013. Intraoperative restoration followed by posterior decompression and plate-rod placement with occipital cortical screws and C2/C3 lateral mass cortical screws fixation devices were used in all patients. Results were recorded both pre- and postoperatively and these outcome measures included Nurick grading (NG) and radiology findings (atlantodental interval (ADI), space available for the spinal cord (SAC), interval between odontoid and Chamberlain's line (IOC), and the cervicomedullary angle (CMA)). RESULTS: Forty (93%) of the 43 patients were followed up. Thirty-six (90%) patients' symptoms improved and four (10%) stabilized. No patients became progressively worse. The difference between preoperative and postoperative Nurick grades was statistically significant. All patients achieved restoration, including thirty (75%) patients had full restoration and ten (25%) had part restoration. The size of syringomyelia was obviously decreased in 32 (80%) patients and stable in 8 (20%) patients. All radiology findings (ADI, IOC, SAC, CMA) showed significant changes from pre- to postoperative (p < 0.01). CONCLUSION: Intraoperative distraction, extension combined posterior decompression with use of plate-rod-screws occipitocervical fusion device is an effective method to treat AAD, BI and CHM with syringomyelia. SN - 1019-5149 UR - https://www.unboundmedicine.com/medline/citation/27400111/Surgical_Management_of_Adult_Reducible_Atlantoaxial_Dislocation_Basilar_Invagination_and_Chiari_Malformation_with_Syringomyelia_ L2 - http://www.turkishneurosurgery.org.tr/pubmed.php3?year=2016&amp;volume=26&amp;issue=4&amp;page=615 DB - PRIME DP - Unbound Medicine ER -