Basilar invagination: craniocervical instability treated with cervical traction and occipitocervical fixation. Case report.
The upward odontoid displacement observed in basilar invagination (BI) is generally associated with a horizontal clivus and craniocervical kyphosis, conditions that exert ventral compression at the spinomedullary junction. Ventral brainstem decompression by reduction or elimination of the odontoid invagination is part of the desired treatment. The authors describe a case of BI in an adult, who was effectively treated with the easy and safe reduction of odontoid invagination via cervical traction. Normalization of kyphosis at the craniovertebral junction and the vertical position of both a previously horizontal clivus and the cerebellar tentorium demonstrated that these conditions were not part of the original malformation but instead were caused by a reducible craniovertebral instability.
Botelho
Ricardo V
RV
Spinal Group, Neurosurgical Service, Hospital do Servidor Público Estadual de São Paulo, Brazil. bitbot@uol.com.br
Neto
Eliseu B
EB
Patriota
Gustavo C
GC
Daniel
Jefferson W
JW
Dumont
Paulo A S
PA
Rotta
José M
JM
D000328:Adult; D001269:Atlanto-Occipital Joint; D006801:Humans; D007593:Joint Instability / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D010985:Platybasia / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D011859:Radiography; D013123:Spinal Fusion; D014143:Traction