{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T20:16:36Z","timestamp":1782332196363,"version":"3.54.5"},"reference-count":22,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T00:00:00Z","timestamp":1728864000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2023YFC2509700"],"award-info":[{"award-number":["2023YFC2509700"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The objective of this study was to analyze failed posterior fossa decompression (PFD) in patients with basilar invagination and atlantoaxial dislocation (BI\u2010AAD). Revision surgery in these patients is challenging and has been rarely reported. In addition, the anatomical variations of the vertebral artery increase the risk of revision surgery. Here, we introduce the implementation of a new type of one\u2010stage posterior revision surgery, whose difficulties and effects are summarized.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 21 patients with BI\u2010AAD who underwent PFD were retrospectively analyzed in our center from November 2017 to April 2021. The revision surgery in all patients was performed through the posterior approach. The Japanese Orthopaedic Association (JOA) score and the Short Term 12 (SF\u201012) score were employed to evaluate the clinical symptoms and health status. The distance from the tip of the odontoid to Chamberlain's line (DCL), the atlantodental interval (ADI), the clivus\u2010canal angle (CCA), the diameter of the subarachnoid space (DSS), and the craniovertebral junction triangular area (CTA) were assessed radiographically. The pre\u2010 and postoperative results were compared by paired <jats:italic>t<\/jats:italic> test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The data of 21 consecutive patients were reviewed, with an average follow\u2010up period of 28\u2009\u00b1\u200914\u2009months. Postoperative imaging showed effectively reduced compression of BI\u2010AAD. No implant failure or neurovascular injury occurred. Eleven patients had vertebral artery abnormalities, but none had vertebral artery injury. All patients had evidence of bone fusion on the CT scan images within a 12\u2010month follow\u2010up period. The JOA and SF\u201012 scores were significantly improved 1\u2009year postoperatively (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Posterior surgery using the technique of interarticular distraction, fusion with cage grafting, and fixation is a safe and effective revision surgery to treat patients with basilar invagination and atlantoaxial dislocation who failed PFD, which will result in good outcome.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.14252","type":"journal-article","created":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T02:39:34Z","timestamp":1728959974000},"page":"3088-3097","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Analysis of Failed Posterior Fossa Decompression and an Effective Revision Surgery in Patients with Basilar Invagination and Atlantoaxial Dislocation"],"prefix":"10.1111","volume":"16","author":[{"given":"Maoyang","family":"Qi","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Xuanwu Hospital, Capital Medical University  Beijing China"},{"name":"Lab of Spinal Cord Injury and Functional Reconstruction Xuanwu Hospital, Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yueqi","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Xuanwu Hospital, Capital Medical University  Beijing China"},{"name":"Spine Center, China International Neuroscience Institute (CHINA\u2010INI)  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boyan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Xuanwu Hospital, Capital Medical University  Beijing China"},{"name":"Lab of Spinal Cord Injury and Functional Reconstruction Xuanwu Hospital, Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zong","family":"Xin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Xuanwu Hospital, Capital Medical University  Beijing China"},{"name":"Lab of Spinal Cord Injury and Functional Reconstruction Xuanwu Hospital, Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Can","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Xuanwu Hospital, Capital Medical University  Beijing China"},{"name":"Spine Center, China International Neuroscience Institute (CHINA\u2010INI)  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenlei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Xuanwu Hospital, Capital Medical University  Beijing China"},{"name":"Spine Center, China International Neuroscience Institute (CHINA\u2010INI)  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Guan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Xuanwu Hospital, Capital Medical University  Beijing China"},{"name":"Spine Center, China International Neuroscience Institute (CHINA\u2010INI)  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zuowei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Xuanwu Hospital, Capital Medical University  Beijing China"},{"name":"Spine Center, China International Neuroscience Institute (CHINA\u2010INI)  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengzeng","family":"Jian","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Xuanwu Hospital, Capital Medical University  Beijing China"},{"name":"Lab of Spinal Cord Injury and Functional Reconstruction Xuanwu Hospital, Capital Medical University  Beijing China"},{"name":"Spine Center, China International Neuroscience Institute (CHINA\u2010INI)  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanru","family":"Duan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Xuanwu Hospital, Capital Medical University  Beijing China"},{"name":"Lab of Spinal Cord Injury and Functional Reconstruction Xuanwu Hospital, Capital Medical University  Beijing China"},{"name":"Spine Center, China International Neuroscience Institute (CHINA\u2010INI)  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0104-115X","authenticated-orcid":false,"given":"Zan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Xuanwu Hospital, Capital Medical University  Beijing China"},{"name":"Lab of Spinal Cord Injury and Functional Reconstruction Xuanwu Hospital, Capital Medical University  Beijing China"},{"name":"Spine 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