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Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
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Lesson learned in endoscopic endonasal dens resection for C1-C2 spinal cord decompression
Irene Portonero1,2, Enrico Lo Bue3,4, Federica Penner3,4
1Neurosurgery Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy. irene.portonero@unito.it.
Summary
Endoscopic endonasal odontoidectomy (EEO) is a safe and effective technique for spinal cord decompression. This study shares surgical tips to encourage wider adoption of this challenging endoscopic endonasal approach (EEA).
Area of Science:
- Neurosurgery
- Minimally Invasive Surgery
Background:
- Endoscopic endonasal approach (EEA) is recognized as the safest and most effective method for odontoidectomy.
- However, its widespread adoption is limited, despite its efficacy.
Purpose of the Study:
- To share ten years of experience and surgical tips for endoscopic endonasal odontoidectomy (EEO).
- To encourage the use of EEO by addressing its technical complexities.
Main Methods:
- Retrospective analysis of 21 patients (34-84 years) with ventral spinal cord compression due to non-reducible CVJ malformation.
- Treatment involved EEA performed between July 2011 and March 2019.
Main Results:
- The study reported an intraoperative cerebrospinal fluid (CSF) leak rate of 9.5%.
- No post-operative CSF leaks were observed, indicating a safe outcome.
Conclusions:
- Endoscopic endonasal odontoidectomy (EEO) is a safe and valid technique for decompressing cervical neural structures.
- Despite technical challenges, sharing experience-based tips can promote wider use of EEO.
