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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2017; 36(04): 260-263
DOI: 10.1055/s-0037-1608882
Technical Note | Nota Técnica
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Direct Intraoperative Reduction of Basilar Invagination Associated with Atlantoaxial Subluxation – Technical Note

Redução intraoperatória direta da invaginação basilar associada a subluxação atlantoaxial – nota técnica
Victor Emmanuel Passos Barretto
1   Hospital Dr. Mario Gatti, Campinas, São Paulo, Brazil
3   Department of Neurosurgery, Hospital Municipal Dr. Mário Gatti, Campinas, São Paulo, Brazil
,
Camila Andrade de Sousa
2   Department of Neurosurgery, Hospital Santa Casa de Limeira, Limeira, São Paulo, Brazil
,
Anderson Loureiro
3   Department of Neurosurgery, Hospital Municipal Dr. Mário Gatti, Campinas, São Paulo, Brazil
,
Diogo Arruda
3   Department of Neurosurgery, Hospital Municipal Dr. Mário Gatti, Campinas, São Paulo, Brazil
,
Anderson Matos
3   Department of Neurosurgery, Hospital Municipal Dr. Mário Gatti, Campinas, São Paulo, Brazil
,
Andrei Fernandes Joaquim
3   Department of Neurosurgery, Hospital Municipal Dr. Mário Gatti, Campinas, São Paulo, Brazil
4   Department of Neurosurgery, Universidade Estadual de Campinas (Unicamp), Campinas, São Paulo, Brazil
› Institutsangaben
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Publikationsverlauf

02. August 2017

17. Oktober 2017

Publikationsdatum:
06. Dezember 2017 (online)

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Abstract

In the present article, we describe a technique of direct intraoperative reduction of congenital atlantoaxial subluxation associated with severe basilar invagination and atlas assimilation. It consists of a wide dissection of the craniovertebral junction, exposing the region between the superior facet of C2 and the occiput (described as a “pseudoarticulation” by some authors). After exposure, a self-rotating small dissector or Kobe is used bilaterally, pushing C2 anteriorly and inferiorly, with reduction of the dislocation, followed by craniovertebral fixation. The technique is safe and eliminates the need for an anterior approach to the odontoid reduction, as well as the need to dissect the C1–2 joint.

Resumo

Neste artigo, descrevemos a técnica de redução intraoperatória direta de subluxação atlantoaxial congênita associada a invaginação basilar grave e assimilação do atlas. Ela consiste em ampla dissecção da junção craniovertebral, expondo a região entre a face superior da C2 e o osso occipital (descrita como uma “pseudoarticulação” por alguns autores). Após exposição, um descolador pequeno ou Kobe é usado bilateralmente com rotação própria, deslocando C2 anterior e inferiormente, com redução da luxação, seguido de fixação craniovertebral. A técnica é segura e elimina a necessidade de uma abordagem anterior para a ressecção do odontoide, além de evitar a dissecação da junta C1–C2.

Keywords

basilar invagination - atlantoaxial subluxation - technical note - intraoperative reduction

Palavras-chave

invaginação basilar - subluxação atlantoaxial - nota técnica - redução intraoperatória
 

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