{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:07:16Z","timestamp":1791893236550,"version":"4.3.4"},"reference-count":32,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2007,12]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Basilar impression (BI) secondary to osteogenesis imperfecta (OI) is a rare but debilitating condition that is often progressive unless it is halted. More recently, ventral decompression surgery has been advocated for this condition. This study is a retrospective review of the 21-year experience of ventral decompression surgery and dorsal occipitocervical fixation in patients with BI secondary to OI and is the largest patient series reported to date.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Twenty patients treated between 1982 and 2003 by the senior author at the authors' institution were included in this study. All patients underwent ventral decompression surgery followed by dorsal craniocervical stabilization. Patients were followed up for a median of 10 years.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>There were no intraoperative or perioperative deaths. Postoperatively, 16 of 20 (80%) patients showed objective improvement or maintained their good preoperative level of function. After surgery, of the 15 patients admitted with Karnofsky Performance Scale (KPS) scores of 70% or less, 11 improved, two remained unchanged, one patient's condition deteriorated, and one patient died of an unrelated cause. Of five patients admitted with a KPS score of 80% or greater, no patient's condition deteriorated in the short- and midterm period, but one patient had recurrence 15 years after surgery. At the end of follow-up, 25% of the patients had recurrence of brainstem compression symptoms or had died, and 15% showed no improvement after surgery. All of the remaining patients (60%) had sustained a long-term benefit from surgery.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Aggressive ventral decompression surgery and dorsal stabilization for patients with BI secondary to OI can not only halt disease progression but can also produce a good and sustainable long-term functional outcome, even in those patients who present as severely symptomatic. Patients who presented early with minor symptoms had good long-term outcomes.<\/jats:p><\/jats:sec>","DOI":"10.3171\/spi-07\/12\/594","type":"journal-article","created":{"date-parts":[[2007,12,13]],"date-time":"2007-12-13T21:37:59Z","timestamp":1197581879000},"page":"594-600","source":"Crossref","is-referenced-by-count":49,"title":["Basilar impression and osteogenesis imperfecta: a 21-year retrospective review of outcomes in 20 patients"],"prefix":"10.3171","volume":"7","author":[{"given":"Ahmed G.","family":"Ibrahim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. Alan","family":"Crockard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0070594","series-title":"\u00dcber die Kretinen, eine besondere Menschenabart in den Alpen","author":"Ackermann","year":"1790"},{"key":"b2-0070594","series-title":"Paediatr Drugs","doi-asserted-by":"publisher","first-page":"465","DOI":"10.2165\/00128072-200002060-00005","article-title":"Osteogenesis imperfecta: practical treatment guidelines","volume":"2","author":"Antoniazzi","year":"2000"},{"key":"b3-0070594","series-title":"Museum Anatomicum Holmiense: section pathologica, Fasiculus primus","author":"Berg","year":"1855"},{"key":"b4-0070594","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1004","DOI":"10.3171\/jns.2003.99.6.1004","article-title":"A prospective controlled study of sleep respiratory events in patients with craniovertebral junction malformation","volume":"99","author":"Botelho","year":"2003"},{"key":"b5-0070594","series-title":"Brain","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1093\/brain\/78.2.229","article-title":"The radiological criteria and familial occurrence of primary basilar impression","volume":"78","author":"Bull","year":"1955"},{"key":"b6-0070594","series-title":"Yale J Biol Med","first-page":"487","article-title":"Basilar impression (platybasia): bizarre developmental anatomy of occipital bone and upper cervical spine with striking and misleading neurologic manifestation","volume":"11","author":"Chamberlain","year":"1939"},{"key":"b7-0070594","series-title":"J Neurol Psychiatry","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1136\/jnnp.3.3.241","article-title":"Basilar impression of the skull","volume":"3","author":"De Vet","year":"1940"},{"key":"b8-0070594","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1016\/S0090-3019(82)80033-5","article-title":"Basilar impression and platybasia in osteogenesis imperfecta tarda","volume":"17","author":"Frank","year":"1982"},{"key":"b9-0070594","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1227\/00006123-199011000-00016","article-title":"The operative management of basilar impression in osteogenesis imperfecta","volume":"27","author":"Harkey","year":"1990"},{"key":"b10-0070594","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1136\/jnnp.66.3.357","article-title":"Basilar impression complicating osteogenesis imperfecta type IV: the clinical and neuroradiological findings in four cases","volume":"66","author":"Hayes","year":"1999"},{"key":"b11-0070594","series-title":"Dtsch Z Nervenheilkd","first-page":"1","article-title":"Zur Kenntnis der rhachitischen Deformationen der Sch\u00e4delbasis und der basalen Sch\u00e4delhyperostosen","volume":"20","author":"Homen","year":"1901"},{"key":"b12-0070594","series-title":"Brain","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1093\/brain\/83.1.138","article-title":"Basilar impression and osteogenesis imperfecta in a family","volume":"83","author":"Hurwitz","year":"1960"},{"key":"b13-0070594","series-title":"Jikken Dobutsu","first-page":"189","article-title":"[Congenital malformation of the skeleton in Weiser-Maples guinea pigs.]","volume":"41","author":"Inaba","year":"1992"},{"key":"b14-0070594","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1227\/00006123-199109000-00012","article-title":"Surgical access to the base of skull and upper cervical spine by extended maxillotomy","volume":"29","author":"James","year":"1991"},{"key":"b15-0070594","series-title":"Am J Med Genet A","first-page":"350","article-title":"Vestibular dysfunction in adult patients with osteogenesis imperfecta","volume":"120","author":"Kuurila","year":"2003"},{"key":"b16-0070594","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1136\/jnnp.12.1.61","article-title":"Platybasia: with case report","volume":"12","author":"Mayerszky","year":"1949"},{"key":"b17-0070594","series-title":"Brit J Radiol","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1259\/0007-1285-21-244-171","article-title":"The significance of certain measurements of the skull in the diagnosis of basilar impression","volume":"21","author":"McGregor","year":"1948"},{"key":"b18-0070594","series-title":"Brain","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1093\/brain\/73.3.405","article-title":"Basilar impression of the skull","volume":"73","author":"O'Connell","year":"1950"},{"key":"b19-0070594","series-title":"J Bone Joint Surg Br","first-page":"233","article-title":"Basilar impression in osteogenesis imperfecta. A report of three cases in one family","volume":"66","author":"Pozo","year":"1984"},{"key":"b20-0070594","series-title":"Ann Surg","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1097\/00000658-194208000-00008","article-title":"Platybasia with involvement of the central nervous system","volume":"116","author":"Ray","year":"1942"},{"key":"b21-0070594","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1136\/jnnp.58.6.665","article-title":"Trigeminal neuralgia associated with osteogenesis imperfecta","volume":"58","author":"Reilly","year":"1995"},{"key":"b22-0070594","series-title":"Pediatr Radiol","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1007\/BF02387909","article-title":"Basilar impression and osteogenesis imperfecta in a three-year-old girl: CT and MRI","volume":"19","author":"Rush","year":"1989"},{"key":"b23-0070594","series-title":"Technol Health Care","doi-asserted-by":"publisher","first-page":"143","DOI":"10.3233\/THC-2000-8205","article-title":"Vertebral stress of a cervical spine model under dynamic load","volume":"8","author":"Sadegh","year":"2000"},{"key":"b24-0070594","series-title":"J Neurosurg","doi-asserted-by":"publisher","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"},{"key":"b25-0070594","series-title":"Wien Med Wochenschr","first-page":"2594","article-title":"Zur Roentgendiagnose der basilaren Impression des Sch\u00e4dels","volume":"61","author":"Schuller","year":"1911"},{"key":"b26-0070594","series-title":"Calcif Tissue Int","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1007\/s00223-001-1055-5","article-title":"The effect of intravenous pamidronate on bone mineral density, bone histomorphometry, and parameters of bone turnover in adults with type IA osteogenesis imperfecta","volume":"72","author":"Shapiro","year":"2003"},{"key":"b27-0070594","series-title":"Pediatr Radiol","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1007\/BF02011910","article-title":"Craniocervical abnormalities in osteogenesis imperfecta: genetic and molecular correlation","volume":"24","author":"Sillence","year":"1994"},{"key":"b28-0070594","series-title":"Brain","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1093\/brain\/80.1.11","article-title":"Developmental abnormalities in the region of the foramen magnum","volume":"80","author":"Spillane","year":"1957"},{"key":"b29-0070594","series-title":"Arch Neurol","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1001\/archneur.1964.00460170045008","article-title":"Clinical syndromes associated with basilar impression","volume":"10","author":"Taylor","year":"1964"},{"key":"b30-0070594","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"573","DOI":"10.3171\/jns.1996.84.4.0573","article-title":"Pediatric transoral surgery: indications, complications, and long-term outcome","volume":"84","author":"Tuite","year":"1996"},{"key":"b31-0070594","series-title":"Beitr\u00e4ge zur physischen Anthropologie der Deutschen, mit besonderer Ber\u00fccksichtigung der Friesen","author":"Virchow","year":"1876"},{"key":"b32-0070594","series-title":"J Bone Joint Surg Br","first-page":"184","article-title":"Paraplegia in osteogenesis imperfecta: a case report","volume":"65","author":"Ziv","year":"1983"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/7\/6\/article-p594.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/7\/6\/article-p594.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/7\/6\/article-p594.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T23:31:26Z","timestamp":1681601486000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/7\/6\/article-p594.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,12]]},"references-count":32,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/spi-07\/12\/594","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2007,12]]}}}