{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T11:26:23Z","timestamp":1792063583637,"version":"4.4.0"},"reference-count":71,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>BACKGROUND:<\/jats:title>\n                  <jats:p>Ventral decompression with posterior stabilization is the preferred treatment for symptomatic irreducible basilar invagination. Endoscopic image-guided transcervical odontoidectomy (ETO) may allow for decompression with limited morbidity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>OBJECTIVE:<\/jats:title>\n                  <jats:p>To describe the perioperative outcomes of patients undergoing anterior decompression of basilar invagination with the use of ETO.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>Fifteen patients who had a follow-up of at least 16 months were retrospectively reviewed. Intraoperatively, the vertebral body of C2 was removed and the odontoid was resected in a \u201ctop-down\u201d manner using endoscopic visualization and frameless stereotactic navigation. Posterior instrumented stabilization was subsequently performed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>The average (\u00b1 standard deviation) age of the patients was 42.6 \u00b1 24.5 (range, 11\u201372) years. Postoperative complications occurred in 6 patients, including a urinary tract infection (n = 2), upper airway swelling (n = 2), dysphagia (n = 2), gastrostomy tube placement (n = 1), and an asymptomatic pseudomeningocele (n = 1). No patients required a tracheostomy, had bacterial meningitis, or developed a venous thromboembolic event; only 1 patient was intubated for more than 48 hours postoperatively. With a mean follow-up of 41.9 \u00b1 14.4 (range, 16\u201359) months, myelopathy improved in all patients and no patient experienced late neurological deterioration. The mean modified Japanese Orthopedic Association (JOA) score increased from 11.2 \u00b1 4.2 to 15.9 \u00b1 1.4 (P = .002). Patients with a diagnosis other than rheumatoid arthritis or who had a higher preoperative JOA score had a significantly better postoperative neurological recovery (P = .005).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSION:<\/jats:title>\n                  <jats:p>ETO may be a valid treatment for patients with symptomatic irreducible basilar invagination that avoids some of the morbidity of transoral surgery and leads to long-term improvement in myelopathy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1227\/neu.0b013e318230e59a","type":"journal-article","created":{"date-parts":[[2011,8,6]],"date-time":"2011-08-06T09:35:29Z","timestamp":1312623329000},"page":"351-360","source":"Crossref","is-referenced-by-count":65,"title":["Endoscopic Image-Guided Transcervical Odontoidectomy"],"prefix":"10.1227","volume":"70","author":[{"given":"Hormuzdiyar H.","family":"Dasenbrock","sequence":"first","affiliation":[{"name":"School of Medicine, Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle J.","family":"Clarke","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic Medical Center, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Bydon","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel M.","family":"Sciubba","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy F.","family":"Witham","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziya L.","family":"Gokaslan","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Paul","family":"Wolinsky","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2011,6,8]]},"reference":[{"issue":"6","key":"2020022604303894300_R1-23","doi-asserted-by":"crossref","first-page":"594","DOI":"10.3171\/SPI-07\/12\/594","article-title":"Basilar impression and osteogenesis imperfecta: a 21-year retrospective review of outcomes in 20 patients","volume":"7","author":"Ibrahim","year":"2007","journal-title":"J Neurosurg Spine"},{"issue":"6","key":"2020022604303894300_R2-23","doi-asserted-by":"crossref","first-page":"950","DOI":"10.3171\/jns.1997.86.6.0950","article-title":"Basilar invagination in osteogenesis imperfecta and related osteochondrodysplasias: medical and surgical management","volume":"86","author":"Sawin","year":"1997","journal-title":"J Neurosurg"},{"issue":"4","key":"2020022604303894300_R3-23","doi-asserted-by":"crossref","first-page":"354","DOI":"10.3171\/SPI.2008.9.10.354","article-title":"Endoscopic transnasal decompression for management of basilar invagination in osteogenesis imperfecta","volume":"9","author":"Hansen","year":"2008","journal-title":"J Neurosurg Spine"},{"issue":"9","key":"2020022604303894300_R4-23","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1007\/s00586-008-0706-x","article-title":"C1-C2 arthrodesis after transoral odontoidectomy and suboccipital craniectomy for ventral brain stem compression in Chiari I patients","volume":"17","author":"Hwang","year":"2008","journal-title":"Eur Spine J"},{"issue":"3","key":"2020022604303894300_R5-23","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1227\/01.NEU.0000365770.10690.6F","article-title":"Basilar invagination","volume":"66","author":"Smith","year":"2010","journal-title":"Neurosurgery"},{"issue":"6 suppl operative","key":"2020022604303894300_R6-23","first-page":"319","article-title":"A new technique for intraoperative reduction of occipitocervical instability","volume":"66","author":"Hsu","year":"2010","journal-title":"Neurosurgery"},{"issue":"4","key":"2020022604303894300_R7-23","doi-asserted-by":"crossref","first-page":"337","DOI":"10.3171\/PED\/2008\/1\/4\/337","article-title":"Endoscopic transcervical odontoidectomy for pediatric basilar invagination and cranial settling","volume":"1","author":"McGirt","year":"2008","journal-title":"Report of 4 cases. 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