Medknow Publications on behalf of the Neurological Society of India
Abstract
Objective: A novel method of treatment of basilar invagination that
involves distraction of the atlantoaxial joint using specially designed
spiked spacers is described. Bone graft that is additionally placed
within the appropriately prepared atlantoaxial joint and posterior to
the arch of atlas and lamina of C2 provides bony fusion. Materials and
Methods: Between December 2002 and April 2007, 11 patients underwent
the discussed method of fixation at the Department of Neurosurgery,
King Edward Memorial Hospital in Mumbai, India. All 11 patients had
"congenital" basilar invagination and the symptoms were progressive in
nature. Results: The mean follow-up period was 21 months (range 8-40
months). Neurological improvement and successful distraction with
atlantoaxial stabilization and ultimate bone fusion was achieved in all
the patients and was documented with dynamic radiography. There were no
neurological, vascular, or infective complications. Conclusions: We
conclude that the described method of atlantoaxial joint distraction
and fixation provides an alternative treatment strategy for cases with
basilar invagination. "Joint distraction" as a stand-alone method could
provide reduction of basilar invagination and firm stabilization in
such cases
