C1-2 Fusion in Atlantoaxial Dislocation and Basilar Invagination with and without Chiari Malformation: Clinical/Radiological and Craniometric Results

作者全名："Zhu, Haitao; Xu, Rui; Wang, Shengxi; Xia, Haijian; Yan, Yi; Xia, Yongzhi"

作者地址："[Zhu, Haitao] Chongqing Med Univ, Dept Gen Practice, Affiliated Hosp 1, Chongqing, Peoples R China; [Xu, Rui; Wang, Shengxi; Xia, Haijian; Yan, Yi; Xia, Yongzhi] Chongqing Med Univ, Dept Neurosurg, Affiliated Hosp 1, Chongqing, Peoples R China"

通信作者："Xia, YZ (通讯作者)，Chongqing Med Univ, Dept Neurosurg, Affiliated Hosp 1, Chongqing, Peoples R China."

来源：WORLD NEUROSURGERY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001028558700001

JCR分区：Q2

影响因子：1.9

年份：2023

卷号：175

期号：　

开始页：E1017

结束页：E1024

文献类型：Article

关键词：Atlantoaxial dislocation; Basilar invagination; Chiari malformation; Craniocervical junction malformation; Posterior cranial fossa

摘要："-OBJECTIVE: Patients with Chiari malformation (CM) associated with atlantoaxial dislocation (AAD) and basilar invagination (BI) may present with a small posterior cranial fossa, but data on the volumetric analysis are lacking. Additionally, whether additional foramen magnum decom-pression (FMD) is needed together with atlantoaxial fusion remains controversial. This study evaluated the volumetric alterations of the posterior cranial fossa in these patients and analyzed the radiological and clinical outcomes after posterior C1-C2 reduction and fixation plus C1 posterior arch resection. -METHODS: Thirty-two adult CM patients with AAD and BI (CM-AAD/BI group) and 21 AAD and BI patients without CM (AAD/BI-only group) who received posterior atlan-toaxial fusion plus C1 posterior arch resection were retrospectively studied. The clinical and radiological out-comes and volumetric measurements of the posterior cra- -ial fossa were evaluated. -RESULTS: The majority of CM-AAD/BI patients (94%) improved clinically and radiologically at 12 mo post-operatively, and none required additional FMD. Morpho-logical analysis revealed a significant reduction in the bony posterior cranial fossa volumes of the CM-AAD/BI group (P < 0.01) and the AAD/BI-only group (P < 0.01) relative to those of the CM group. No significant differences were observed between the CM-AAD/BI and AAD/BI groups. - CONCLUSIONS: Compared with patients with simple CM, patients with AAD/BI with or without CM demon- strated a considerably and equally reduced bony posterior cranial fossa volume. No additional FMD is needed in the treatment of CM-AAD/BI patients after posterior reduction and fusion plus C1 posterior arch resection."

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