{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T05:10:46Z","timestamp":1772860246760,"version":"3.50.1"},"reference-count":19,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,2,5]]},"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p>The use of tubular retractors in minimally invasive spine surgery has been described extensively in the literature. However, there are only select reports discussing their use specifically in a transoral approach for upper cervical pathologies such as an epidural abscess and a dystrophic os odontoideum.<\/jats:p>\n               <jats:p>We report the first use of a transtubular transoral approach in a rare case of an adult presenting with severe neck pain with progressing neurologic signs secondary to atlantoaxial Pott\u2019s disease. Debridement and partial odontoidectomy performed using this approach allowed less trauma to surrounding soft tissues without sacrificing an excellent visualisation of the operative field. A halo vest was applied to provide temporary stability. The patient transitioned out of his halo vest after 6 months while completing medical therapy after a year without need for further intervention. The transtubular transoral approach is a suitable alternative to the conventional approach in patients with atlantoaxial Pott\u2019s disease.<\/jats:p>","DOI":"10.1136\/bcr-2020-239240","type":"journal-article","created":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T10:56:44Z","timestamp":1614682604000},"page":"e239240","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Transoral approach using a tubular retractor system in the treatment of atlantoaxial Pott\u2019s disease: a novel method of surgical decompression"],"prefix":"10.1136","volume":"14","author":[{"given":"Karla Teresa Salda\u00f1a","family":"Araneta","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Philippine General Hospital, Manila, Metro Manila, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael","family":"Bundoc","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Philippine General Hospital, Section of Spine Surgery, University of the Philippines Manila, Manila, Metro Manila, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,3,2]]},"reference":[{"key":"2025082703222087000_14.3.e239240.1","first-page":"1","article-title":"Microendoscopic discectomy (Med) for surgical management of lumbar disc disease: technical note","volume":"2","author":"Nakagawa","year":"2005","journal-title":"Int J Spine Surg"},{"key":"2025082703222087000_14.3.e239240.2","doi-asserted-by":"crossref","first-page":"50","DOI":"10.5704\/MOJ.1603.009","article-title":"Transtubular transoral surgery for excision of a dystrophic os Odontoideum: a case report","volume":"10","author":"Ariffin","year":"2016","journal-title":"Malays Orthop J"},{"key":"2025082703222087000_14.3.e239240.3","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.inat.2017.07.016","article-title":"Use of a tubular retractor for transoral odontoidectomy of upper cervical epidural phlegmon extraction and abscess drainage","volume":"10","author":"Zaninovich","year":"2017","journal-title":"Interdiscip Neurosurg"},{"key":"2025082703222087000_14.3.e239240.4","unstructured":"Bormann RPB , Dunn RN . Atlanto-Axial tuberculosis: a report on five cases. SA Orthopaed J 2005:34\u20139."},{"key":"2025082703222087000_14.3.e239240.5","doi-asserted-by":"crossref","first-page":"127","DOI":"10.4103\/ijmy.ijmy_55_17","article-title":"Atlantoaxial tuberculosis: outcome analysis","volume":"6","author":"Sridharan","year":"2017","journal-title":"Int J Mycobacteriol"},{"key":"2025082703222087000_14.3.e239240.6","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1302\/0301-620X.69B2.3818746","article-title":"Atlanto-Axial tuberculosis in adults","volume":"69-B","author":"Lifeso","year":"1987","journal-title":"J Bone Joint Surg Br"},{"key":"2025082703222087000_14.3.e239240.7","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-200301000-00009"},{"key":"2025082703222087000_14.3.e239240.8","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3100833"},{"key":"2025082703222087000_14.3.e239240.9","doi-asserted-by":"publisher","DOI":"10.4184\/asj.2012.6.4.294"},{"key":"2025082703222087000_14.3.e239240.10","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1016\/j.wneu.2016.04.028","article-title":"Minimally invasive surgical approach for odontoid lesions: a technical description in a case of high cervical osteomyelitis and abscess","volume":"91","author":"Riley","year":"2016","journal-title":"World Neurosurg"},{"key":"2025082703222087000_14.3.e239240.11","doi-asserted-by":"crossref","first-page":"16","DOI":"10.3171\/jns.1989.71.1.0016","article-title":"The transoral approach to the superior cervical spine. A review of 53 cases of extradural cervicomedullary compression","volume":"71","author":"Hadley","year":"1989","journal-title":"J Neurosurg"},{"key":"2025082703222087000_14.3.e239240.12","doi-asserted-by":"crossref","first-page":"245","DOI":"10.3340\/jkns.2007.42.4.245","article-title":"Clinical applications of the tubular retractor on spinal disorders","volume":"42","author":"Kim","year":"2007","journal-title":"J Korean Neurosurg Soc"},{"key":"2025082703222087000_14.3.e239240.13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3171\/foc.2002.13.2.6","article-title":"Use of a tubular retractor system in microscopic lumbar discectomy: 1 year prospective results in 135 patients","volume":"13","author":"Palmer","year":"2002","journal-title":"Neurosurg Focus"},{"key":"2025082703222087000_14.3.e239240.14","first-page":"294","article-title":"A new table-fixed retractor for anterior odontoid screw fixation: technical note","volume":"98","author":"Hott","year":"2003","journal-title":"J Neurosurg"},{"key":"2025082703222087000_14.3.e239240.15","doi-asserted-by":"crossref","DOI":"10.14444\/2056","article-title":"Mitr) surgical approach for cervical pyogenic C1-2 abscess: a case report","volume":"9","author":"Aranibar","year":"2015","journal-title":"Int J Spine Surg"},{"key":"2025082703222087000_14.3.e239240.16","doi-asserted-by":"crossref","first-page":"e485","DOI":"10.1097\/SCS.0b013e3182903467","article-title":"Strategy to minimize oral mucosal tear and lip injury in facial contouring and orthognathic surgery","volume":"24","author":"Zhao","year":"2013","journal-title":"Journal of Craniofacial Surgery"},{"key":"2025082703222087000_14.3.e239240.17","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/S0901-5027(05)80618-6","article-title":"Oropharyngeal morbidity following transoral approaches to the upper cervical spine","volume":"27","author":"Jones","year":"1998","journal-title":"Int J Oral Maxillofac Surg"},{"key":"2025082703222087000_14.3.e239240.18","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1097\/01.bsd.0000169062.77005.78","article-title":"Minimally invasive anterior approach to upper cervical spine","volume":"18","author":"Fong","year":"2005","journal-title":"J Spinal Disord Tech"},{"key":"2025082703222087000_14.3.e239240.19","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1007\/978-3-7091-0673-0_4","article-title":"Advances in videoassisted anterior surgical approach to the craniovertebral junction","volume":"37","author":"Visocchi","year":"2011","journal-title":"Adv Tech Stand Neurosurg"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-239240","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T10:22:30Z","timestamp":1756290150000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-239240"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3]]},"references-count":19,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,3,2]]},"published-print":{"date-parts":[[2021,3]]}},"alternative-id":["10.1136\/bcr-2020-239240"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-239240","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3]]}}}