Basilar impression in osteogenesis imperfecta: can it be treated with halo traction and posterior fusion?
Basilar impression (BI) and hydrocephalus complicating osteogenesis imperfecta (OI) is usually treated by anterior transoral decompression and posterior fixation. Nevertheless, it may be questioned if posterior fusion following axial halo traction is adequate in patients with symptomatic BI complicating OI. We report on a case with progressive symptomatic hydrocephalus and BI complicating OI that was successfully treated by halo traction followed by posterior occipitocervical fusion. However, after a symptom free interval of 2 years the patient suffered from recurrence of symptomatic hydrocephalus needing additional ventriculoperitoneal (VP) shunt placement. In conclusion, posterior fusion without additional VP shunt placement may not be effective in the long term for ameliorating symptoms and signs and halting progressive hydrocephalus in BI complicating OI.
Noske
D P
DP
Department of Neurosurgery, VU University Medical Center, Amsterdam, The Netherlands.
van Royen
B J
BJ
Bron
J L
JL
Vandertop
W P
WP
D000328:Adult; D001139:Arnold-Chiari Malformation / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D001269:Atlanto-Occipital Joint / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D001270:Cervical Atlas / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D003388:Cranial Fossa, Posterior / Q000000981:diagnostic imaging / Q000473:pathology; D016267:External Fixators / Q000592:standards; D020546:Fourth Ventricle / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D020547:Lateral Ventricles / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods / Q000592:standards; D009777:Occipital Bone / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D010013:Osteogenesis Imperfecta / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D010985:Platybasia / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D011859:Radiography; D012008:Recurrence; D019291:Skull Base / Q000000981:diagnostic imaging / Q000473:pathology; D013123:Spinal Fusion / Q000379:methods / Q000592:standards*; D014143:Traction / Q000295:instrumentation / Q000592:standards*; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt / Q000592:standards