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Related Experiment Videos

Basilar invagination: a study based on 190 surgically treated patients

A Goel1, M Bhatjiwale, K Desai

  • 1Department of Neurosurgery, King Edward Memorial Hospital and Seth Gordhandas Sunderdas Medical College, Parel, Bombay, India.

Journal of Neurosurgery
|June 3, 1998
PubMed
Summary

For basilar invagination, transoral surgery is best for patients without Chiari malformation, while foramen magnum decompression suits those with it. Fixation is often needed for the former group post-surgery.

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Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Neurology

Background:

  • Basilar invagination is a complex condition affecting the skull base and cervical spine.
  • Accurate diagnosis and classification are crucial for determining optimal surgical management.
  • Chamberlain's criteria (1939) remain a basis for diagnosing basilar invagination.

Purpose of the Study:

  • To evaluate the efficacy of different surgical procedures for basilar invagination.
  • To correlate specific surgical approaches with patient subgroups based on associated pathologies.
  • To guide surgical decision-making in managing basilar invagination.

Main Methods:

  • Analysis of 190 patients diagnosed with basilar invagination.
  • Classification into two groups: Group I (basilar invagination without Chiari malformation) and Group II (basilar invagination with Chiari malformation).

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  • Assessment of pathological characteristics including brainstem compression and posterior cranial fossa volume.

    • Main Results:

    • Group I patients experienced direct brainstem compression from the odontoid process.
    • Group II patients presented with reduced posterior cranial fossa volume.
    • Anterior brainstem concavity was noted in both groups.

    Conclusions:

    • Transoral surgery is the preferred approach for Group I patients.
    • Foramen magnum decompression is indicated for Group II patients.
    • Post-operative fixation is frequently required for Group I but rarely for Group II.