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01-05-2012 | Original Article

Endoscopic transnasal odontoid resection to decompress the bulbo-medullary junction: a reliable anterior minimally invasive technique without posterior fusion

Authors: Maurizio Gladi, Maurizio Iacoangeli, Nicola Specchia, Massimo Re, Mauro Dobran, Lorenzo Alvaro, Elisa Moriconi, Massimo Scerrati

Published in: European Spine Journal | Special Issue 1/2012

Abstract

Purpose

Anterior decompression of the craniovertebral junction is reserved to patients with irreducible ventral bulbo-medullary lesions and rapidly deteriorating neurological functions. Classically performed through the transoral approach, the exposure of this region can be now achieved by a minimally invasive endonasal endoscopic approach (EEA).

Methods

Four patients with irreducible, anterior bulbo-medullary compression due to rheumatoid pannus and basilar invagination were enrolled. The imaged-guided EEA was used to resect the odontoid process, trying to preserve the C1 anterior arch.

Results

Neurological improvement and adequate bulbo-medullary decompression were obtained in all patients. In two cases, anterior C1 ring was preserved. These patients did not required a posterior fusion.

Conclusions

Compared with the standard transoral technique, the EEA provides the same good exposure but with potentially less complications. The preservation of the anterior C1 arch can contribute to avoid cranial settling and posterior fusion with its related risk of subaxial instability.

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Title: Endoscopic transnasal odontoid resection to decompress the bulbo-medullary junction: a reliable anterior minimally invasive technique without posterior fusion
Authors: Maurizio Gladi
Maurizio Iacoangeli
Nicola Specchia
Massimo Re
Mauro Dobran
Lorenzo Alvaro
Elisa Moriconi
Massimo Scerrati
Publication date: 01-05-2012
Publisher: Springer-Verlag
Published in: European Spine Journal / Issue Special Issue 1/2012
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-012-2220-4

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Endoscopic transnasal odontoid resection to decompress the bulbo-medullary junction: a reliable anterior minimally invasive technique without posterior fusion

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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