title: [Treatment strategies for complicated craniocervical junction malformations].
abstract: OBJECTIVE
  To explore the treatment strategies for complicated craniocervical junction malformations with diverse clinical and imaging features.
  
  
  METHODS
  The clinical data of 67 cases of complicated craniocervical junction malformation treated between January 2000 to December 2010 were retrospectively analyzed. Based on their clinical manifestations and imaging findings, different operative procedures were adopted, including odontoidectomy via transoral transpharyngeal approach (n = 3), occipito-cervical fusion and(or) suboccipital decompression (n = 19) and odontoidectomy via transoral transpharyngeal approach followed by occipito-cervical fusion in two-stage operation (n = 25). Four cases underwent merely odontoidectomy via transoral transpharyngeal approach and died postoperatively. Sixteen cases had occipito-cervical fusion and(or) transorally surgical release for reduction in one stage.
  
  
  RESULTS
  Clinical symptoms significantly improved in 19 cases, partially improved in 21 cases and remained unchanged in 12 cases. Nine cases deteriorated postoperatively and 6 cases died. The effective rate was 59.7%.
  
  
  CONCLUSIONS
  The complexity of craniocervical junction malformations may be fully assessed based on different clinical manifestations and thorough imaging studies. Then personalized operative plans are to be designed.
authors.affiliation: Department of Neurosurgery, Henan Provincial People's Hospital, Zhengzhou, China. adam7055@sina.com
authors.forename: Hang
authors.initials: H
authors.lastname: Chen
authors.forename: Hai-Yang
authors.initials: HY
authors.lastname: Li
authors.forename: Chao
authors.initials: C
authors.lastname: Wang
authors.forename: Xi-Wen
authors.initials: XW
authors.lastname: Shi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001268:Atlanto-Axial Joint / Q000002:abnormalities / Q000601:surgery*; D016025:Bone Transplantation / Q000379:methods; D002648:Child; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult