Endoscopic transcervical anterior release and posterior fixation in the treatment of irreducible vertical atlantoaxial dislocation

• DOI: 10.1007/s00586-014-3352-5
• Publication Date: 2014-05-15T17:53:43Z
• Authors: Hong Ma; Guohua Lv; Bing Wang; Lei Kuang; Xiaobin Wang
• Keywords: Joint Dislocations; Endoscopy; Middle Aged; Decompression, Surgical; Radiography; 03 medical and health sciences; Spinal Fusion; Treatment Outcome; 0302 clinical medicine; Atlanto-Axial Joint; Cervical Vertebrae; Humans; Female

Vertical atlantoaxial dislocation is a type of atlantoaxial instability with upper cervical spinal cord compression. The transoral ondontoid resection with posterior fixation is the gold standard for ventral decompression. Results are satisfying though surgery can be challenging due to its invasiveness. The endoscopic transcervical anterior release could provide sufficient ventral decompression with less collateral damage. In the illustrative case, anatomic reduction was achieved with significant improvement in neurological function and radiographic parameters. Endoscopic transcervical anterior release and posterior fixation appears to be a viable and interesting alternative for the treatment of vertical atlantoaxial dislocation in properly selected individuals, and its implementation could significantly reduce the post-surgical complications.