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Original Article
16 (
1
); 37-42
doi:
10.56018/bjkines2024067

Cranio-vertebral junction anomalies with Atlanto-axial instability: Management and complications- Our experience of 63 cases at a tertiary care center in India

Assistant Professor at Department of Neurosurgery, Government Medical College and Sir T. Hospital, Bhavnagar, Gujarat.
Assistant Professor, Department of Neurosurgery, B.J. Medical college, Civil Hospital, Asarwa, Ahmedabad, Gujarat.
Assistant Professor, Department of Neurosurgery, PDU Medical College and Civil Hospital, Rajkot, Gujarat.
Professor And Head of Department, Department Of Neurosurgery,B.J. Medical college, Civil Hospital, Asarwa, Ahmedabad, Gujarat.
3rd Year Senior Resident Doctor, Department Of Neurosurgery, B.J. Medical college, Civil Hospital, Asarwa, Ahmedabad

*Corresponding author:Dr Milap Parmar Email ID: milap.parmar18@gmail.com

Licence
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

Abstract

Introduction

Management of complex cranio-vertebral junction anomalies with atlanto-axial instability require extensive pre-operative work up with various intra-operative (and/or preoperative)manouvres and bony fusion procedures and post-operative rehabilitation and support. This study focuses on various management strategies in terms of its outcome and complications.

Materials and methodology:

This clinical analytical study shares our experience of 63 cases of cv junction anomalies with atlanto-axial instability operated at tertiary care center in india. 63 patients operated during the period spanning from June-2019 to November-2021 who had atlanto axial instability (AAD WITH/WITHOUT BI). Patients were assessed pre-operatively and post-operatively up to 3 months objectively and subjectively in terms of outcome and post op radiology was also done.

Results:

Out of 63 atlanto-axial operated patients, 42 improved, 3 had stable disease and 12 deteriorated clinically some of whom required also secondary procedures for it. Out of 63 ,8 patients had died,4 of them were pediatric and 4 were adults. Various procedure related complications occurred in 12 patients.

Conclusion:

Thus, with proper pre-operative diagnosis of type of congenital anomaly combined with appropriate surgical plan can give impacting results in these pathologies with minimal complications.

Keywords

cranio-vertebral junction anomalies
atlanto-axial instability
DCER
C1-C2 fusion

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