The battle against an invisible enemy

Excerpt

We have read with great interest the article by Arthur Wagner et al., “Chiari malformation type I and basilar invagination originating from atlantoaxial instability: a literature review and critical analysis [1].” The article discusses a controversial topic of “to do, how much to do, or not to do.” It provides a critical evaluation of the iconoclastic theory by Goel of one-size-fits-all management for all kinds of craniovertebral (CVJ) anomalies [2]. Every new concept has to prove its mettle and for it to be university acceptable, the reproducibility of the results remains a basic requirement. This statement remains especially valid in the field of neurosurgery where we deal with extremely unforgiving neural tissues in the close vicinity of critical neurovascular structures, and the results vary with the experience and the competence of surgeon. This article is a review of the publications supporting or refuting the hypothesis based on their respective clinical results on this abnormality. …