Craniovertebral anomalies: a study of 82 cases

Area of Science:

• Neurosurgery
• Orthopedics
• Pediatric Neurology

Background:

• Craniovertebral anomalies present a spectrum of complex congenital conditions affecting the skull base and upper cervical spine.
• These anomalies can lead to significant neurological deficits and require specialized management.
• Early and accurate diagnosis is crucial for effective treatment and improved patient outcomes.

Purpose of the Study:

• To analyze the clinical features and surgical outcomes of patients with craniovertebral anomalies.
• To identify common anomaly combinations and diagnostic clues.
• To evaluate the efficacy of surgical intervention in this patient cohort.

Main Methods:

• Retrospective analysis of 82 cases of craniovertebral anomalies.
• Detailed review of clinical presentations, diagnostic findings, and surgical procedures.
• Assessment of patient outcomes following surgical management.

Main Results:

• Congenital atlanto-axial dislocation was the most frequent anomaly (56.1%).
• Multiple anomalies were common (48.8%), frequently involving combinations like atlanto-axial dislocation with occipitalisation of atlas or basilar invagination with Arnold-Chiari malformation.
• Neck deformity or low hairline were significant diagnostic clues (50%).
• Surgical intervention resulted in improvement for 72% of patients, with a low mortality rate.

Conclusions:

• Congenital atlanto-axial dislocation is the predominant craniovertebral anomaly, often occurring with other malformations.
• Clinical signs such as neck deformity and low hairline are valuable diagnostic indicators.
• Surgical treatment offers significant benefits for patients with craniovertebral anomalies, leading to substantial neurological improvement.