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Stress Maneuver for Basilar Invagination Reduction: A Technical Report
Marco Túlio Domingos Silva E Reis1, François Dantas2, Weverson José Teodoro Lacerda3
1Department of Neurosurgery - Hospital São Francisco de Assis, Belo Horizonte, Minas Gerais, Brazil; Department of Neurosurgery - Biocor Instituto/Rede D'Or, Nova Lima, Minas Gerais, Brazil.
Background:
Basilar invagination (BI) is a prolapse of the odontoid process cranially and posteriorly towards the foramen magnum. Several surgical treatment options are available for this condition. Herein, we describe a stress maneuver technique for BI reduction using a single-stage posterior approach.
Methods:
We described the case of a 56-year-old male diagnosed with type A BI and brainstem compression, who was treated with posterior fossa decompression and occipitocervical fusion. The BI was reduced intraoperatively using a stress maneuver, and cranial traction or atlantoaxial joint distraction was not necessary.
Results:
Postoperative imaging revealed a reduction of the odontoid process and adequate brainstem decompression. The patient showed progressive improvement of his symptoms.
Conclusions:
In selected cases, stress maneuvers for BI reduction can be a less morbid, easier, and replicable option within the already existing technical arsenal.
