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Transoral Odontoidectomy - Our Experience in A Limited-Resource Setup
Riaz Ur Rehman1, Muhammad Shaheer Akhtar1, Amna Bibi2
1Department of Neurosurgery, Lady Reading Hospital, Peshawar, Pakistan.
World Neurosurgery
|June 14, 2022
Summary
Transoral odontoidectomy effectively treats basilar invagination and atlantoaxial dislocation, improving neurological function. This procedure is safe and feasible even in resource-limited settings with careful patient selection.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spinal Deformity Correction
Background:
- Posterior approaches are standard for basilar invagination.
- Transoral decompression is crucial for complex cases with severe degeneration and neural compression.
Purpose of the Study:
- To evaluate the safety and efficacy of transoral odontoidectomy for basilar invagination and atlantoaxial dislocation.
- To assess neurological, clinical, and radiological outcomes in patients undergoing this procedure.
Main Methods:
- Retrospective study of 33 patients undergoing transoral odontoidectomy between June 2016 and January 2022.
- Analysis of preoperative and postoperative neurological, clinical, and radiological parameters.
- Comparison of patient outcomes based on selected metrics.
Main Results:
- Significant improvement in gait abnormalities and neck pain reported by most patients.
- Postoperative improvement in Nurick and Modified Japanese Orthopedic Association scores (P < 0.05).
- Seven patients had anomalous vertebral artery courses; three required reoperation, including one with vertebral artery injury.
Conclusions:
- Transoral odontoidectomy is a safe and effective treatment for basilar invagination and atlantoaxial dislocation.
- Proper patient selection is key to successful outcomes in limited-resource settings.
