{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T19:17:25Z","timestamp":1777317445165,"version":"3.51.4"},"reference-count":7,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T00:00:00Z","timestamp":1738540800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T00:00:00Z","timestamp":1738540800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Yuksek Ihtisas University"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Spine J"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background &amp; objectives<\/jats:title>\n            <jats:p>Basilar invagination (BI) represents a complex anomaly of the craniovertebral junction, characterized by the displacement of the odontoid process towards the foramen magnum. Current surgical interventions include anterior decompression and combined anterior-posterior decompression with posterior fusion. Traditional methods for odontoid resection encompass transoral, transnasal, and endonasal approaches. However, these techniques are fraught with significant risks. Furthermore, the restricted exposure provided by the endonasal corridor\u2019s anatomical limitations hampers surgical manipulation, prompting spine surgeons to seek alternative techniques. This report details a case of BI managed through an endoscopic posterolateral odontoidotomy, showcasing an innovative surgical approach. We aim to describe our experience in partially removing the odontoid via posterolateral approach with a novel endoscopic technique, preventing the need for additional approach and related complications.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A 16-year-old male patient presented with complaints of imbalance and difficulty swallowing. Clinical examination revealed upper extremity muscle weakness, ataxic gait, and dysphagia. Upon the diagnosis of BI, a posterior occipito-cervical fusion was performed. However, six months postoperatively, the patient returned with exacerbated symptoms. During the subsequent surgical intervention, the odontoid body was resected using a posterolateral transmass endoscopic approach. Due to the patient\u2019s neck and shoulder anatomy, cranial angulation of the endoscope was restricted, necessitating the retention of the odontoid tip.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Post-operative CT revealed that the tip was closer to the base and a subarachnoid space was formed. Follow-up CT after a year showed a complete migration of the tip to the base of C2 with a clear decompression of the brainstem.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Our findings demonstrate that partial or total resection of the odontoid process via a posterolateral approach is feasible using endoscopic techniques. The endoscopic posterolateral transmass odontoidotomy should be considered a viable alternative method and route for patients necessitating partial or total odontoidectomy.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00586-025-08688-1","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T02:57:38Z","timestamp":1738551458000},"page":"1256-1262","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A new technique: endoscopic transmass odontoidotomy"],"prefix":"10.1007","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6719-5522","authenticated-orcid":false,"given":"Ismail","family":"Bozkurt","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulkun Unlu","family":"Unsal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salim","family":"Senturk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali Fahir","family":"Ozer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,2,3]]},"reference":[{"issue":"3","key":"8688_CR1","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1016\/j.nec.2007.04.005","volume":"18","author":"P Klimo Jr","year":"2007","unstructured":"Klimo P Jr, Rao G, Brockmeyer D (2007) Congenital anomalies of the cervical spine. Neurosurg Clin N Am 18(3):463\u2013478","journal-title":"Neurosurg Clin N Am"},{"key":"8688_CR2","unstructured":"Bertrand G (1982) Anomalies of the craniovertabral junction. In: Youmans JR, ed. Neurological Surgery. 2nd ed. Saunders;:1484\u20131486"},{"issue":"6","key":"8688_CR3","doi-asserted-by":"publisher","first-page":"549","DOI":"10.3171\/2010.2.PEDS09362","volume":"5","author":"TC Hankinson","year":"2010","unstructured":"Hankinson TC, Grunstein E, Gardner P, Spinks TJ, Anderson RC (2010) Transnasal odontoid resection followed by posterior decompression and occipitocervical fusion in children with Chiari malformation type I and ventral brainstem compression. J Neurosurg Pediatr 5(6):549\u2013553","journal-title":"J Neurosurg Pediatr"},{"key":"8688_CR4","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1016\/j.clineuro.2016.07.019","volume":"148","author":"MF Shriver","year":"2016","unstructured":"Shriver MF, Kshettry VR, Sindwani R, Woodard T, Benzel EC, Recinos PF (2016) Transoral and transnasal odontoidectomy complications: a systematic review and meta-analysis. Clin Neurol Neurosurg 148:121\u2013129. https:\/\/doi.org\/10.1016\/j.clineuro.2016.07.019","journal-title":"Clin Neurol Neurosurg"},{"issue":"3","key":"8688_CR5","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1007\/s007010200029","volume":"144","author":"A Alfieri","year":"2002","unstructured":"Alfieri A, Jho HD, Tschabitscher M (2002) Endoscopic endonasal approach to the ventral cranio-cervical junction: anatomical study. Acta Neurochir (Wien) 144(3):219\u2013225. https:\/\/doi.org\/10.1007\/s007010200029","journal-title":"Acta Neurochir (Wien)"},{"issue":"3","key":"8688_CR6","doi-asserted-by":"publisher","first-page":"E12","DOI":"10.3171\/2022.12.FOCUS22624","volume":"54","author":"\u0130 Do\u011fan","year":"2023","unstructured":"Do\u011fan \u0130, Bayatli E, Eray HA, et al. (2023) Single-institution comparative analysis for odontoid resection: posterior transaxis versus anterior transnasal approach. Neurosurg Focus 54(3):E12. https:\/\/doi.org\/10.3171\/2022.12.FOCUS22624","journal-title":"Neurosurg Focus"},{"key":"8688_CR7","doi-asserted-by":"publisher","first-page":"e566","DOI":"10.1016\/j.wneu.2024.03.176","volume":"186","author":"Y Guvenc","year":"2024","unstructured":"Guvenc Y, Topal B, Verimli U, Biyikli E, Akdeniz E, Ziyal \u0130 (2024) Posterolateral Paramass Approach to lesions located at the anterior C1-2 level: a cadaver study. World Neurosurg 186:e566\u2013e576. https:\/\/doi.org\/10.1016\/j.wneu.2024.03.176","journal-title":"World Neurosurg"}],"container-title":["European Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00586-025-08688-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00586-025-08688-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00586-025-08688-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T16:02:48Z","timestamp":1744732968000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00586-025-08688-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,3]]},"references-count":7,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["8688"],"URL":"https:\/\/doi.org\/10.1007\/s00586-025-08688-1","relation":{},"ISSN":["0940-6719","1432-0932"],"issn-type":[{"value":"0940-6719","type":"print"},{"value":"1432-0932","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,3]]},"assertion":[{"value":"4 September 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 January 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 January 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 February 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was carried out according to the latest revision of the Helsinki Declaration regarding medical research involving human subjects. Informed written consent was acquired from the patient and legal guardians before the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"A written patient consent form from the patient and parents was obtained.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Patient consent was obtained from the patient and legal guardians prior to the study to allow the publication of the results and all radiological images.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"No potential conflict of interest was reported by the authors. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosure"}},{"value":"The authors have no competing interests related to this study.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}