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Modified Goel’s Methods for Basilar Impression: A Case Report with Literature

We report the case of a 57-year-old woman who had basilar impression manifesting as severe myelopathy and occipital neuralgia and was treated by distraction and fixation performed using a modification of Goel’s method. Magnetic resonance imaging (MRI) and computed tomography (CT) scans showed severe...

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Autores principales: Asamoto, Shunji, Fukui, Yasuyuki, Nishiyama, Makoto, Ishikawa, Masayuki, Nakamura, Satoshi, Nagashima, Masaki, Muto, Jun, Jimbo, Hiroyuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japan Neurosurgical Society 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5386157/
https://www.ncbi.nlm.nih.gov/pubmed/28663991
http://dx.doi.org/10.2176/nmccrj.cr.2015-0049
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author Asamoto, Shunji
Fukui, Yasuyuki
Nishiyama, Makoto
Ishikawa, Masayuki
Nakamura, Satoshi
Nagashima, Masaki
Muto, Jun
Jimbo, Hiroyuki
author_facet Asamoto, Shunji
Fukui, Yasuyuki
Nishiyama, Makoto
Ishikawa, Masayuki
Nakamura, Satoshi
Nagashima, Masaki
Muto, Jun
Jimbo, Hiroyuki
author_sort Asamoto, Shunji
collection PubMed
description We report the case of a 57-year-old woman who had basilar impression manifesting as severe myelopathy and occipital neuralgia and was treated by distraction and fixation performed using a modification of Goel’s method. Magnetic resonance imaging (MRI) and computed tomography (CT) scans showed severe myelocompression by the dens of the axis from the ventral side and occipitalization of the atlas. After traction using a Halo vest, C1–2 facet distraction and fixation was performed in one stage using a modified Goel’s method. Although Goel et al. used a custom-made spacer to distract the facet joints, we used a threaded titanium cylindrical cage that was inserted into the joint to fix the C1–2 facet joint with posterior fixation from occipital bone to C5. Postoperatively, gradual symptomatic and neurological amelioration were observed. The atlantoaxial joints were bone-fused at 3 years post-operation. Distraction and fixation performed using this modified version of Goel’s method was effective for treating basilar invagination. The threaded titanium cylindrical cage provided adequate C1–2 space and strong initial fixation.
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spelling pubmed-53861572017-06-29 Modified Goel’s Methods for Basilar Impression: A Case Report with Literature Asamoto, Shunji Fukui, Yasuyuki Nishiyama, Makoto Ishikawa, Masayuki Nakamura, Satoshi Nagashima, Masaki Muto, Jun Jimbo, Hiroyuki NMC Case Rep J Case Report We report the case of a 57-year-old woman who had basilar impression manifesting as severe myelopathy and occipital neuralgia and was treated by distraction and fixation performed using a modification of Goel’s method. Magnetic resonance imaging (MRI) and computed tomography (CT) scans showed severe myelocompression by the dens of the axis from the ventral side and occipitalization of the atlas. After traction using a Halo vest, C1–2 facet distraction and fixation was performed in one stage using a modified Goel’s method. Although Goel et al. used a custom-made spacer to distract the facet joints, we used a threaded titanium cylindrical cage that was inserted into the joint to fix the C1–2 facet joint with posterior fixation from occipital bone to C5. Postoperatively, gradual symptomatic and neurological amelioration were observed. The atlantoaxial joints were bone-fused at 3 years post-operation. Distraction and fixation performed using this modified version of Goel’s method was effective for treating basilar invagination. The threaded titanium cylindrical cage provided adequate C1–2 space and strong initial fixation. The Japan Neurosurgical Society 2015-09-11 /pmc/articles/PMC5386157/ /pubmed/28663991 http://dx.doi.org/10.2176/nmccrj.cr.2015-0049 Text en Copyright © 2016 The Japan Neurosurgical Society This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Case Report
Asamoto, Shunji
Fukui, Yasuyuki
Nishiyama, Makoto
Ishikawa, Masayuki
Nakamura, Satoshi
Nagashima, Masaki
Muto, Jun
Jimbo, Hiroyuki
Modified Goel’s Methods for Basilar Impression: A Case Report with Literature
title Modified Goel’s Methods for Basilar Impression: A Case Report with Literature
title_full Modified Goel’s Methods for Basilar Impression: A Case Report with Literature
title_fullStr Modified Goel’s Methods for Basilar Impression: A Case Report with Literature
title_full_unstemmed Modified Goel’s Methods for Basilar Impression: A Case Report with Literature
title_short Modified Goel’s Methods for Basilar Impression: A Case Report with Literature
title_sort modified goel’s methods for basilar impression: a case report with literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5386157/
https://www.ncbi.nlm.nih.gov/pubmed/28663991
http://dx.doi.org/10.2176/nmccrj.cr.2015-0049
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