Treatment of primary basilar invagination by cervical traction and posterior instrumented reduction together with occipitocervical fusion
Abstract
STUDY DESIGN: This retrospective study was conducted to analyze the radiographic and clinical results in seven patients with primary basilar invagination who accepted a combination of continuous cervical traction before operation and posterior screw/rod system reduction together with occipitocervical fusion.
OBJECTIVE: To evaluate the radiographic and clinical outcomes of this treatment regimen in combination of continuous cervical traction and posterior instrumented reduction with pedicle screw/rod system.
SUMMARY OF BACKGROUND DATA: Primary basilar invagination poses considerable difficulties in the surgical management regarding surgical approach, reduction, and decompression. A variety of methods have been described to treat primary basilar invagination and all methods existed limits.
METHODS: There were four male and three female patients, and the ages ranged from 12 to 40 years (average age, 22.3 yr). Six patients presented neurologic deficits. The Nurick scale was from 1 grade to 4 grades (average, 2.7 grades). The distance of the odontoid tip in relation to Wackenheim line, atlantodental interval, Klaus height index, craniospinal angle, modified Omega angle, and cervicomedullary angle were measured pretreated and after surgery. When the tip of odontoid process was inferior or approximate to Wackenheim line and McRae line after cervical traction, the operation of reduction and fixation should be accepted.
RESULTS: After surgery, the mean Wackenheim value and…
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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