C1C2 Distraction and Compression Technique for Craniovertebral Junction Anomalies with Basilar Invagination and Irreducible Atlantoaxial Dislocation

Abstract

The authors describe four cases of basilar invagination (BI) with irreducible atlantoaxial dislocation (AAD) by distraction and compression technique. The article describes the technique in detail and the principles of the reduction achieved in all the planes by C1C2 screw placement, the cage insertion in the C1C2 joint, and manipulation of the joint. They described in the literature well-discussed various modifications and their application for treatment of BI with irreducible AAD.

Keywords

basilar invagination - craniovertebral junction anomaly - irreducible atlantoaxial dislocation

• References

• 1 Menezes AH. Craniovertebral junction anomalies: diagnosis and management. Semin Pediatr Neurol 1997; 4 (03) 209-223
• 2 Goel A, Bhatjiwale M, Desai K. Basilar invagination: a study based on 190 surgically treated patients. J Neurosurg 1998; 88 (06) 962-968
• 3 Goel A, Laheri V. Plate and screw fixation for atlanto-axial subluxation. Acta Neurochir (Wien) 1994; 129 (01) (02) 47-53
• 4 Goel A, Desai KI, Muzumdar DP. Atlantoaxial fixation using plate and screw method: a report of 160 treated patients. Neurosurgery 2002; 51 (06) 1351-1356 discussion 1356–1357
• 5 Chandra PS, Kumar A, Chauhan A, Ansari A, Mishra NK, Sharma BS. Distraction, compression, and extension reduction of basilar invagination and atlantoaxial dislocation: a novel pilot technique. Neurosurgery 2013; 72 (06) 1040-1053 discussion 1053
• 6 Chandra PS, Prabhu M, Goyal N, Garg A, Chauhan A, Sharma BS. Distraction, compression, extension, and reduction combined with joint remodeling and extra-articular distraction: description of 2 new modifications for its application in basilar invagination and atlantoaxial dislocation: prospective study in 79 cases. Neurosurgery 2015; 77 (01) 67-80 discussion 80
• 7 Nurick S. The pathogenesis of the spinal cord disorder associated with cervical spondylosis. Brain 1972; 95 (01) 87-100
• 8 Smith JS, Shaffrey CI, Abel MF, Menezes AH. Basilar invagination. Neurosurgery 2010; 66 (03) Suppl 39-47
• 9 Teodori JB, Painter MJ. Basilar impression in children. Pediatrics 1984; 74 (06) 1097-1099
• 10 Wadia NH. Myelopathy complicating congenital atlanto-axial dislocation. (A study of 28 cases.). Brain 1967; 90 (02) 449-472
• 11 Goel A, Kulkarni AG, Sharma P. Reduction of fixed atlantoaxial dislocation in 24 cases: technical note. J Neurosurg Spine 2005; 2 (04) 505-509
• 12 Goel A. Treatment of basilar invagination by atlantoaxial joint distraction and direct lateral mass fixation. J Neurosurg Spine 2004; 1 (03) 281-286
• 13 Salunke P, Sharma M, Sodhi HB, Mukherjee KK, Khandelwal NK. Congenital atlantoaxial dislocation: a dynamic process and role of facets in irreducibility. J Neurosurg Spine 2011; 15 (06) 678-685
• 14 Jian FZ, Chen Z, Wrede KH, Samii M, Ling F. Direct posterior reduction and fixation for the treatment of basilar invagination with atlantoaxial dislocation. Neurosurgery 2010; 66 (04) 678-687 discussion 687
• 15 Suh BG, Padua MR, Riew KD. et al. A new technique for reduction of atlantoaxial subluxation using a simple tool during posterior segmental screw fixation: clinical article. J Neuro-surg Spine 2013; 19 (02) 160-166
• 16 Yin YH, Qiao GY, Yu XG, Tong HY, Zhang YZ. Posterior realignment of irreducible atlantoaxial dislocation with C1-C2 screw and rod system: a technique of direct reduction and fixation. Spine J 2013; 13 (12) 1864-1871
• 17 Chandra PS. In reply. Neurosurgery 2014; 74 (01) E148-E150
• 18 Deepak AN, Salunke P, Sahoo SK, Prasad PK, Khandelwal NK. Revisiting the differences between irreducible and reducible atlantoaxial dislocation in the era of direct posterior approach and C1-2 joint manipulation. J Neurosurg Spine 2017; 26 (03) 331-340
• 19 Salunke P, Sahoo S, Khandelwal NK, Ghuman MS. Technique for direct posterior reduction in irreducible atlantoaxial dislocation: multi-planar realignment of C1-2. Clin Neurol Neurosurg 2015; 131: 47-53