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Options limited for occipitocervical fusion performed for a cranial defect
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In the setting of a craniectomy defect there are limited options for performing an occipitocervical fusion, but the technique may mitigate some of the complications associated with occipital screw placement, according to the results in a recently published study.
Researchers retrospectively reviewed three pediatric patients, one boy and two girls, with an average age of 13.3 years. Two of the patients underwent prior suboccipital craniectomy surgery for Chiari decompression and the other patient underwent a single-stage suboccipital craniectomy with duraplasty followed by occipitocervical fusion (OCF). Surgeons used an inside-out method for each of the patients, with rods connected to the C1 lateral mass and C2 pars screws.
Preoperatively, the average clivoaxial angle was 127.3°, compared with an average correction to 158° postoperatively, for an overall average correction of 30.6°. The three patients saw complete resolution of their headaches after the procedure by the 12-month follow-up, and none of the patients had perioperative or hardware complications, the researchers noted.
Overall, the researchers found the inside-out technique allowed for safe occipital fixation without the requirement of an intact midline keel. Additionally, the technique may help reduce the chance of complications arising from occipital screw placement and can be used to provide rigid fixation to correct the clivoaxial angle, according to the researchers. – by Robert Linnehan
Disclosure: The researchers report no relevant financial disclosures.
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