1. Posterior Transdural Approach for Odontoidectomy in a Child: Case Report
- Author
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Meena Thatikunta, Jacob Archer, and Andrew Jea
- Subjects
Odontoid process ,medicine.medical_specialty ,Leak ,Adult patients ,business.industry ,Radiography ,Basilar invagination ,General Medicine ,Spinal cord ,medicine.disease ,Prolonged intubation ,Surgery ,03 medical and health sciences ,Dissection ,0302 clinical medicine ,medicine.anatomical_structure ,Spinal cord compression ,030220 oncology & carcinogenesis ,Medicine ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
The transoral transpharyngeal approach is the standard approach to resect the odontoid process and decompress the cervicomedullary spinal cord. There are some significant risks associated with this approach, however, including infection, CSF leak, prolonged intubation or tracheostomy, need for nasogastric tube feeding, extended hospitalization, and possible effects of phonation. Other ventral approaches, such as transmandibular and circumglossal, endoscopic transcervical, and endoscopic transnasal, are also viable alternatives but are technically challenging or may still traverse the nasopharyngeal cavity. Far-lateral and posterior extradural approaches to the craniocervical junction require extensive soft-tissue dissection. Recently, a posterior transdural approach was used to resect retro-odontoid cysts in 3 adult patients. The authors present the case of a 12-year-old girl with Down syndrome and significant spinal cord compression due to basilar invagination and a retro-flexed odontoid process. A posterior transdural odontoidectomy prior to occiptocervical fusion was performed. At 12 months after surgery, the authors report satisfactory clinical and radiographic outcomes with this approach.
- Published
- 2019