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Baaj, Ali A. et al.: 2025 Handbook of Spine Surgery DOI: 10.1055/b-0045-209448
IV: Surgical Techniques

34 Transoral Odontoidectomy

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Editors: Baaj, Ali A.; Mummaneni, Praveen V.; Uribe, Juan S.; Vaccaro, Alexander R.; Greenberg, Mark S.

Authors: Aabedi, Alexander; Abd-El-Barr, Muhammad M.; Adindu, Ebubechi; Agarwal, Nitin; Aguilar-Salinas, Pedro; Alakkad, Salah A.; Alan, Nima; Alanay, Ahmet; Alikhani, Puya; Ammerman, Samuel; Angelov, Ivan; Avila, Mauricio J.; Baeesa, Saleh; Baldwin, Edward L.; Barrera-Arreola, Michelle; Benet, Arnau; Bergin, Stephen M.; Boddapati, Venkat; Bono, Christopher M.; Canseco, Jose A.; Carr, Matthew T.; Chalif, Eric; Chalif, Joshua; Chamberlin, Kelly; Chan, Andrew K.; Chang, Steve W.; Chou, Dean; Chryssikos, Timothy; Chua, Melissa M. J.; Jr, John Clayton Clohisy; Connolly, Ian David; Coumans, Jean-Valery; Coury, Josephine; Dahdaleh, Nader S.; Demirci, Nuri; Deshpande, Rajakumar V.; Diwan, Ashish D.; Elsayed, Galal A.; Emmerich, Juan; Farber, S. Harrison; Feger, Mark A.; Fiani, Brian; Florence, TJ; Fridley, Jared; Gadsden, Jeff; Galgano, Michael; Gandía, Marisa; Ghobrial, George M.; Gokaslan, Ziya; Gonzalez, Glenn A.; Goodwin, C. Rory; Goodwin, Matthew L.; Greenfield, Jeffrey P.; Grossbach, Andrew J.; Gupta, Dhanesh K.; Hadzipasic, Muhamed; Hajtovic, Sabastian; , Colin B. Harris,; Harrop, James S.; Heard, Jeremy C.; Hersh, Andrew M.; Hofstetter, Christoph; Horak, Holli A.; Hou, Brian Q.; Houshiemy, Mohamad Nabih El; Hussein, Amna; Hwang, Steven W.; Jamieson, Alysha; Jamshidi, Aria; Jea, Andrew; Judy, Brendan F.; K., Chaitanya Prabhu; Kawtharani, Sarah; Keister, Alexander; Kepler, Christopher K.; Khan, Asham; Kia, Cameron; Kim, Han Jo; Klineberg, Eric; Kwan, Kevin; Lavadi, Raj Swaroop; Le, Hai; Lee, Joon Y.; Lee, Yunsoo; Lenke, Lawrence G.; Letchuman, Vijay; Levi, Allan D.; Li, Anran; Lu, Yi; Maalouly, Joseph; Macki, Mohamed; Maghrabi, Yazid; Manzano, Glen R.; Marca, Frank La; Menezes, Cristiano Magalhães; Mitha, Alim P.; Molina, Camilo A.; Momin, Eric; Moussalem, Charbel; Noureldine, Mohammad Hassan A.; Orenday-Barraza, Jose Manuel; P., Murali Krishna; Park, Paul; Patel, Kamakshi; Patel, Karan S.; Pathinathan, Kalaventhan; Penumaka, Anirudh; Phillips, Frank M.; Phusoongnern, Woralux; Piazza, Martin G.; Pollina, John; Poonia, Dhiraj Kumar; Quiceno, Esteban; Quillo-Olvera, Javier; Quillo-Reséndiz, Javier; Rao, Prashanth J.; Rasouli, Jonathan J.; Rehman, Azeem A.; Robinson, Leslie; Ruiz-Cardozo, Miguel A.; Saifi, Comron; Saigal, Rajiv; Salomão Junior, Marlus Sérgio Borges; Samdani, Amer F.; Schroeder, Gregory D.; Schwartz, Theodore H.; Sedney, Cara; Shankar, Ganesh M.; Shaw, Jeremy D.; Shen, Yong; Shin, John H.; Singleton, Quante; Sivaganesan, Ahilan; Sivakanthan, Sananthan; Smith, Zachary A.; Soliman, Mohamed A. R.; Sorour, Omar; Steinberger, Jeremy; Stephens, Byron F.; Stephens, Mark; Stippler, Martina; Sunna, Tarek P.; Sykes, David A.W.; Tang, Melissa Yunting; Than, Khoi D.; Theodore, Nicholas; Tosi, Umberto; Unterberger, Ansley; Uschold, Timothy D.; Valdivia, Juan M.; Vaughan, Wilson E.; Head of Orthopedics; Head of Spine Surgery, Spine Surgery Group, Cajuru Hospital, Catholic University of Parana, Curitiba, Parana, Brazil, Emiliano Vialle,; Vignolles-Jeong, Joshua; Villeneuve, Lance; Viñuela-Prieto, Jose Manuel; Vivas, Andrew C.; Voort, Wyatt D. Vander; Waddell, W. Hunter; Wang, Michael Y.; Whaley, James D.; White, Alexandra J.; White, Michael D.; Wick, Joseph; Williamson, Theresa; Wolinsky, Jean-Paul; Xiong, Grace X.; Yahanda, Alexander T.; Yang, Michael J.; Yilgor, Caglar; Yucekul, Altug; Yuk, Frank J.; Zaidi, Hasan; Zhao, Xiaochun; Zhou, James J.

Title: Handbook of Spine Surgery

Print ISBN: 9781684205547; Online ISBN: 9781684206797; Book DOI: 10.1055/b000001054

3. Edition © 2025. Thieme. All rights reserved.
Thieme Medical Publishers, Inc., New York

Subjects: Neurosurgery

Thieme Clinical Collections (English Language)



 
Karan S. Patel, Cameron Kia, Colin B. Harris, and Frank Μ. Phillips

Summary

Transoral odontoidectomy is a surgical technique that can be used for extradural decompression of the upper cervical spine and the brainstem. Severe anterior spinal cord compression due to anterior pathology such as an inflammatory pannus at C1–C2 can be addressed via a transoral odontoidectomy. It can be performed through a transoral and an endoscopic endonasal approach. Common complications of this technique include dysphagia, infection, airway obstruction, dural tear, instability, and vascular injury. Such complications can be avoided by proper preoperative optimization, retractor placement, and antibiotic use. Odontoid resection can often necessitate posterior instrumentation and stabilization. Case series studies have reported significant neurologic improvement in patients who have undergone an anterior transoral odontoidectomy.

Key words

odontoidectomy - C1–C2 compression - inflammatory pannus - transoral approach - craniocervical junction - basilar invagination
 
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