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Related Experiment Video

Updated: Jun 9, 2025

Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
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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.

World Neurosurgery
|October 24, 2024
PubMed
Summary

A novel stress maneuver effectively reduced basilar invagination (BI) in a patient with type A BI and brainstem compression. This technique, used during posterior fossa decompression and occipitocervical fusion, offers a simpler alternative for BI reduction.

Keywords:
Basilar invaginationFusionManeuverOccipitocervicalReduction

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Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Spinal Surgery

Background:

  • Basilar invagination (BI) involves the upward and backward prolapse of the odontoid process towards the foramen magnum.
  • Various surgical interventions exist for managing BI.
  • A novel stress maneuver technique for BI reduction via a posterior approach is presented.

Purpose of the Study:

  • To describe a novel stress maneuver for basilar invagination (BI) reduction.
  • To evaluate the efficacy of this technique in a clinical case.

Main Methods:

  • A 56-year-old male with type A BI and brainstem compression underwent posterior fossa decompression and occipitocervical fusion.
  • Intraoperative reduction of BI was achieved using a stress maneuver.
  • Cranial traction and atlantoaxial joint distraction were not required.

Main Results:

  • Postoperative imaging confirmed successful reduction of the odontoid process and adequate brainstem decompression.
  • The patient experienced progressive symptom improvement following the procedure.

Conclusions:

  • Stress maneuvers represent a viable, less morbid, and easily replicable option for basilar invagination reduction.
  • This technique can be integrated into the existing surgical armamentarium for BI management.