Shkarubo Alexey N, Kuleshov Alexander A, Chernov Ilia V, Vetrile Marchel S
Department of Neurooncology, the N.N. Burdenko Neurosurgery Institute, Moscow, Russia.
Department of Vertebrology, N.N. Priorov Central Institute of Traumatology and Orthopedics, Moscow, Russia.
World Neurosurg. 2017 Jun;102:181-190. doi: 10.1016/j.wneu.2017.02.113. Epub 2017 Mar 6.
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.
Clinical case description.
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.
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.
介绍涉及成功前路稳定C1-C2节段治疗Ⅱ型齿状突内陷合并Ⅰ型Chiari畸形患者的临床病例。
临床病例描述。
两名Ⅱ型齿状突内陷合并Ⅰ型Chiari畸形患者采用经口入路进行手术治疗。两例均先行上颈椎前路减压，然后进行C1-C2节段前路稳定。其中1例在先行后路减压后再行此手术，术后神经症状短暂缓解。两例均使用定制颈椎钢板进行C1-C2节段前路稳定。在超过2年的随访期内，神经症状和Chiari畸形均持续缓解。
前路减压并C1-C2节段前路稳定是一种治疗Ⅰ型Chiari畸形合并Ⅱ型齿状突内陷的新颖且有前景的方法。
