{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T14:14:06Z","timestamp":1754144046216,"version":"3.41.2"},"reference-count":41,"publisher":"The Korean Spinal Neurosurgery Society","issue":"2","license":[{"start":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:00:00Z","timestamp":1751241600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Jiangsu Provincial Key Medical Discipline","award":["ZDXK202228"],"award-info":[{"award-number":["ZDXK202228"]}]},{"DOI":"10.13039\/501100018636","name":"Xuzhou Science and Technology Plan Project","doi-asserted-by":"crossref","award":["KC20139"],"award-info":[{"award-number":["KC20139"]}],"id":[{"id":"10.13039\/501100018636","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["e-neurospine.org"],"crossmark-restriction":true},"short-container-title":["Neurospine"],"published-print":{"date-parts":[[2025,6,30]]},"abstract":"<jats:p>Objective: To explore a surgical technique for completing ventral bone decompression and C1\u20132 plate-screw fixation in the craniocervical junction (CVJ) through nasal approach by stage I at the imaging and physical anatomy levels, and to evaluate its feasibility.Methods: Radiographic parameters of 80 patients with basilar invagination (BI) and 56 with normal CVJ anatomy were retrospectively analyzed. Three-dimensional (3D) reconstructions were performed in 31 patients with BI. Key anatomical landmarks, screw entry points, and fixation trajectories were evaluated. Customized plate-screw constructs were designed. Finally, surgical feasibility was tested on a 3D-printed anatomical model and a cadaveric.Results: In 80 BI patients, the average distances between 4 screw insertion points were 16.04 mm, 21.10 mm, 6.83 mm, and 7.10 mm. C2 lateral mass oblique lengths were 16.81 mm (right) and 17.12 mm (left); C1 lengths were 18.71 mm (right) and 19.07 mm (left), with significant differences between C1 and C2 (p&lt;0.001). A 28.5\u00d714.1-mm titanium plate with 16 mm screws was successfully implanted via the nasal route in the polyether ether ketone 3D-printed BI model and the cadaveric. Radiology indicated that the screws were all in the lateral mass and the plates fit tightly.Conclusion: In BI, transnasal odontoidectomy and plate-screw fixation of C1\u20132 are feasible theoretically. This may enable a new alternative approach for nasal minimally invasive decompression and immobilization, following the completion of biomechanics and clinical trials.<\/jats:p>","DOI":"10.14245\/ns.2449320.660","type":"journal-article","created":{"date-parts":[[2025,6,29]],"date-time":"2025-06-29T21:50:41Z","timestamp":1751233841000},"page":"543-555","update-policy":"https:\/\/doi.org\/10.14245\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Endoscopic Transnasal Approach to Atlantoaxial Decompression and C1\u20132 Fixation in Basilar Invagination of Adults: A Feasibility 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