{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:22:38Z","timestamp":1787764958418,"version":"build-2784847793"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Objectives:<\/jats:title>\n                    <jats:p>Odontoidectomy is a surgical procedure indicated in the setting of various pathologies, with the main goal of decompressing the ventral brain stem and spinal cord as a result of irreducible compression at the craniovertebral junction. The endoscopic endonasal approach has been increasingly used as an alternative to the transoral approach as it provides a straightforward, panoramic, and direct approach to the odontoid process. In addition, intraoperative ultrasound (US) guidance is a technique that can optimize safety and surgical outcomes in this context. It is used as an adjunct to neuronavigation and provides intraoperative confirmation of decompression of craniovertebral junction structures in real time. The authors aim to present the use and safe application of real-time intraoperative US guidance during endonasal endoscopic resection of a retro-odontoid pannus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective chart review of a single case was performed and presented herein as a case report and narrated operative video.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A minimally invasive US transducer was used intraoperatively to guide the resection of a retro-odontoid pannus and confirm spinal cord decompression in real time. Postoperative examination of the patient revealed immediate neurological improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Intraoperative ultrasonography is a well described and useful modality in neurosurgery. However, the use of intraoperative US guidance during endonasal endoscopic approaches to the craniovertebral junction has not been previously described. As demonstrated in this technical note, the authors show that this imaging modality can be added to the ever-evolving armamentarium of neurosurgeons to safely guide the decompression of neural structures within the craniocervical junction with good surgical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jcvjs.jcvjs_117_23","type":"journal-article","created":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T00:00:58Z","timestamp":1701216058000},"page":"433-437","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Real-time ultrasound guidance in the endoscopic endonasal resection of a retro-odontoid pannus: Technical note and case illustration"],"prefix":"10.4103","volume":"14","author":[{"given":"Matthieu D.","family":"Weber","sequence":"first","affiliation":[{"name":"The Ohio State University College of Medicine, Columbus, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilherme","family":"Finger","sequence":"additional","affiliation":[{"name":"The Ohio State University Wexner Medical Center, Department of Neurosurgery, Columbus, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikas","family":"Munjal","sequence":"additional","affiliation":[{"name":"The Ohio State University College of Medicine, Columbus, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle C.","family":"Wu","sequence":"additional","affiliation":[{"name":"The Ohio State University Wexner Medical Center, Department of Neurosurgery, Columbus, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basit","family":"Jawad","sequence":"additional","affiliation":[{"name":"The Ohio State University Wexner Medical Center, Department of Otolaryngology - Head and Neck Surgery, Columbus, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asad S.","family":"Akhter","sequence":"additional","affiliation":[{"name":"The Ohio State University Wexner Medical Center, Department of Neurosurgery, Columbus, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikram B.","family":"Chakravarthy","sequence":"additional","affiliation":[{"name":"The Ohio State University Wexner Medical Center, Department of Neurosurgery, Columbus, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo L.","family":"Carrau","sequence":"additional","affiliation":[{"name":"The Ohio State University Wexner Medical Center, Department of Otolaryngology - Head and Neck Surgery, Columbus, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel M.","family":"Prevedello","sequence":"additional","affiliation":[{"name":"The Ohio State University Wexner Medical Center, Department of Neurosurgery, Columbus, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,11,29]]},"reference":[{"key":"R1-20240904","doi-asserted-by":"crossref","first-page":"S7","DOI":"10.1227\/01.NEU.0000215430.86569.C4","article-title":"Cervical spondylosis anatomy: Pathophysiology and biomechanics","volume":"60","author":"Shedid","year":"2007","journal-title":"Neurosurgery"},{"key":"R2-20240904","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/s13244-016-0530-5","article-title":"The craniocervical junction: Embryology, anatomy, biomechanics and imaging in blunt trauma","volume":"8","author":"Offiah","year":"2017","journal-title":"Insights Imaging"},{"key":"R3-20240904","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.3899\/jrheum.181429","article-title":"Atlanto-axial pannus in patients with and without rheumatoid arthritis","volume":"46","author":"Joyce","year":"2019","journal-title":"J Rheumatol"},{"key":"R4-20240904","doi-asserted-by":"crossref","first-page":"661","DOI":"10.3340\/jkns.2018.0234","article-title":"Upper cervical subluxation and cervicomedullary junction compression in patients with rheumatoid arthritis","volume":"62","author":"Chung","year":"2019","journal-title":"J Korean Neurosurg Soc"},{"key":"R5-20240904","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1093\/rheumatology\/14.1.31","article-title":"Vertical atlanto-axial subluxation in rheumatoid arthritis","volume":"14","author":"Henderson","year":"1975","journal-title":"Rheumatol Rehabil"},{"key":"R6-20240904","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1007\/s00586-010-1629-x","article-title":"Endoscopic transnasal resection of the odontoid: Case series and clinical course","volume":"20","author":"Gempt","year":"2011","journal-title":"Eur Spine J"},{"key":"R7-20240904","doi-asserted-by":"crossref","first-page":"184","DOI":"10.3171\/spi.2007.6.2.184","article-title":"Endoscopic image-guided odontoidectomy for decompression of basilar invagination via a standard anterior cervical approach. 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