[An alternative dorsal fusion technique after transoral dens resection in basilar impression with atlas assimilation].
Current therapy of basilar impression includes transoral dens resection. The essential disadvantage of this procedure is the instability of C1/C2 due to loss of the transverse ligament. We describe two patients in whom this instability was treated by modified screwing. Using MAGERL-screws between C0-C2 an interposition of an iliac graft between the occiput and the arc of C2 was made. Neurological symptoms improved in both patients postoperatively. In both cases stable fusion C0/C2 was achieved with an additional treatment with a HALO-fixateur for eight weeks. In our opinion the combined transoral/dorsal procedure is most suitable and efficient in treatment of basilar impressions. By this approach both, decompression of the myelon as well as stable fusion C0/C2, is achieved.
Neurochirurgische Klinik, Bethesda-Krankenhaus, Wuppertal.
B
B
Kaden
J
J
Schramm
W
W
Koch
L
L
Solymosi
D000293:Adolescent; D000328:Adult; D001863:Bone Screws; D016025:Bone Transplantation; D001270:Cervical Atlas / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D009809:Odontoid Process / Q000473:pathology / Q000601:surgery*; D010985:Platybasia / Q000175:diagnosis / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery; D012086:Reoperation; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000601:surgery; D013123:Spinal Fusion / Q000295:instrumentation*; D013595:Syringomyelia / Q000175:diagnosis / Q000601:surgery