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European Spine Journal

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17-12-2022 | Tetraparesis | Case Report

Atlas invagination through the foramen magnum: expanding the spectrum of craniovertebral junction malformations

Authors: Alberto Benato, Martina Offi, Federico Bianchi, Massimiliano Visocchi, Gianpiero Tamburrini

Published in: European Spine Journal | Issue 7/2023

Abstract

Purpose

Malformations of the craniovertebral junction (CVJ) range from mild, asymptomatic conditions to severe forms of instability with basilar invagination. Rarely, there have been accounts of forms of so-called paramedian basilar invagination, with abnormal bone masses invading the lateral portion of the foramen magnum. All these entities have been comprehensively classified both from an anatomical and embryological standpoint.

Methods

Here, we report a case of a unique CVJ malformation which is not included in any existing classification framework and could represent a novel pathologic entity. We also provide an overview of the pertinent literature.

Results

The patient was a 14-year-old boy with a recent onset of spastic tetraparesis. Radiological studies documented a malformation of the atlas which invaginated through the foramen magnum, causing anterolateral medullary incarceration. Surgical treatment involved posterior decompression with resection of the abnormal bone and occipito-cervical fusion.

Conclusion

Our report enriches the panorama of CVJ malformations, showing how anatomical knowledge and embryological insights constitute the basis for the correct assessment and treatment of these complex entities.

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Title: Atlas invagination through the foramen magnum: expanding the spectrum of craniovertebral junction malformations
Authors: Alberto Benato
Martina Offi
Federico Bianchi
Massimiliano Visocchi
Gianpiero Tamburrini
Publication date: 17-12-2022
Publisher: Springer Berlin Heidelberg
Keywords: Tetraparesis
Invagination
Published in: European Spine Journal / Issue 7/2023
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-022-07500-8

At a glance: The STEP trials

Springer Medicine

Atlas invagination through the foramen magnum: expanding the spectrum of craniovertebral junction malformations

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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