Further cranial settling of the upper cervical spine following odontoidectomy - Report of two cases

Naderi S., Pamir M.

JOURNAL OF NEUROSURGERY, vol.95, no.2, pp.246-249, 2001 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 95 Issue: 2
  • Publication Date: 2001
  • Doi Number: 10.3171/spi.2001.95.2.0246
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.246-249
  • Keywords: basilar invagination, cranial settling, odontoidectomy, transoral approach, FIXATION, FUSION, INSTRUMENTATION, PLATE
  • Dokuz Eylül University Affiliated: No


A variety of diseases may affect the craniovertebral junction and require a decompressive and fusion procedure. Craniovertebral junction instability is expected after a fusion procedure. The authors describe two patients with basilar invagination who underwent transoral odontoidectomy and occipitocervical fixation. Despite an uneventful immediate postoperative course, further cranial settling of the C-2 vertebral body (VB) was demonstrated. One patient experienced neurological deterioration and required a second decompressive procedure, whereas the second patient was asymptomatic and required no additional surgery. It was concluded that the odontoidectomy may have led to horizontal separation of the C-1 lateral masses, resulting in further cranial settling of the C-2 VB, Preservation of one aspect of the C-1 anterior arch minimizes C-1 lateral mass offset and, in turn, further cranial settling of the C-2 VB. In addition, a more rigid fixation of C-2 may minimize the possibility of horizontal separation of the C-1 lateral masses after transoral odontoidectomy.