title: Transoral Decompression and Anterior Stabilization of Atlantoaxial Joint in Patients with Basilar Impression and Chiari Malformation Type I: A Technical Report of 2 Clinical Cases.
abstract: OBJECTIVE
  Presentation of clinical cases involving successful anterior stabilization of the C1-C2 segment in patients with invaginated C2 odontoid process and Chiari malformation type I.
  
  
  METHODS
  Clinical case description.
  
  
  RESULTS
  Two patients with C2 odontoid processes invagination and Chiari malformation type I were surgically treated using the transoral approach. In both cases, anterior decompression of the upper cervical region was performed, followed by anterior stabilization of the C1-C2 segment. In 1 of the cases, this procedure was performed after posterior decompression, which led to transient regression of neurologic symptoms. In both cases, custom-made cervical plates were used for anterior stabilization of the C1-C2 segment. During the follow-up period of more than 2 years, a persistent regression of both the neurologic symptoms and Chiari malformation was observed.
  
  
  CONCLUSIONS
  Anterior decompression followed by anterior stabilization of the C1-C2 segment is a novel and promising approach to treating Chiari malformation type I in association with C2 odontoid process invagination.
authors.affiliation: Department of Neurooncology, the N.N. Burdenko Neurosurgery Institute, Moscow, Russia.
authors.forename: Alexey N
authors.initials: AN
authors.lastname: Shkarubo
authors.affiliation: Department of Vertebrology, N.N. Priorov Central Institute of Traumatology and Orthopedics, Moscow, Russia.
authors.forename: Alexander A
authors.initials: AA
authors.lastname: Kuleshov
authors.affiliation: Department of Neurooncology, the N.N. Burdenko Neurosurgery Institute, Moscow, Russia. Electronic address: ilch@list.ru.
authors.forename: Ilia V
authors.initials: IV
authors.lastname: Chernov
authors.affiliation: Department of Vertebrology, N.N. Priorov Central Institute of Traumatology and Orthopedics, Moscow, Russia.
authors.forename: Marchel S
authors.initials: MS
authors.lastname: Vetrile
mesh_terms: D000293:Adolescent; D000328:Adult; D001139:Arnold-Chiari Malformation / Q000000981:diagnostic imaging / Q000601:surgery*; D001268:Atlanto-Axial Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D019299:Decompression, Surgical / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009055:Mouth / Q000601:surgery; D009809:Odontoid Process / Q000601:surgery; D014057:Tomography, X-Ray Computed
keywords: Anterior stabilization; Basilar impression; Chiari malformation type I; Transoral decompression