Treffer: Anterior Transoral Odontoid Reduction With Clivocervical Fusion in Revision Surgery for Craniovertebral Junction Anomalies: A Case Report and Technical Note.

Title:
Anterior Transoral Odontoid Reduction With Clivocervical Fusion in Revision Surgery for Craniovertebral Junction Anomalies: A Case Report and Technical Note.
Authors:
Liu Z; Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.; Spine Center, China International Neuroscience Institute (China-INI), Beijing, China., Wang Y; Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.; Spine Center, China International Neuroscience Institute (China-INI), Beijing, China., Liu H; The First Hospital of Hebei Medical University, Shijiazhuang, China., Zhang L; Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.; Spine Center, China International Neuroscience Institute (China-INI), Beijing, China., Jia S; Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.; Spine Center, China International Neuroscience Institute (China-INI), Beijing, China., Wang H; Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.; Spine Center, China International Neuroscience Institute (China-INI), Beijing, China., Zhang W; Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.; Spine Center, China International Neuroscience Institute (China-INI), Beijing, China., Yang Y; Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.; Spine Center, China International Neuroscience Institute (China-INI), Beijing, China., Zhao X; Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.; Spine Center, China International Neuroscience Institute (China-INI), Beijing, China., Jian F; Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.; Spine Center, China International Neuroscience Institute (China-INI), Beijing, China., Wang K; Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.; Spine Center, China International Neuroscience Institute (China-INI), Beijing, China., Sun X; The First Hospital of Hebei Medical University, Shijiazhuang, China., Wu H; Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.; Spine Center, China International Neuroscience Institute (China-INI), Beijing, China.
Source:
Orthopaedic surgery [Orthop Surg] 2026 Jan; Vol. 18 (1), pp. 194-201. Date of Electronic Publication: 2025 Dec 14.
Publication Type:
Case Reports; Journal Article
Language:
English
Journal Info:
Publisher: Wiley on behalf of the Chinese Orthopedic Association Country of Publication: Australia NLM ID: 101501666 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1757-7861 (Electronic) Linking ISSN: 17577853 NLM ISO Abbreviation: Orthop Surg Subsets: MEDLINE
Imprint Name(s):
Publication: 2013- : Richmond, Vic. Wiley on behalf of the Chinese Orthopedic Association
Original Publication: Richmond, Vic. : Tianjin : Blackwell Pub. Asia ; Tianjin Hospital, 2009-
MeSH Terms:
Odontoid Process*/surgery , Odontoid Process*/diagnostic imaging , Odontoid Process*/abnormalities , Spinal Fusion*/methods , Atlanto-Axial Joint*/surgery , Atlanto-Axial Joint*/abnormalities , Atlanto-Axial Joint*/diagnostic imaging , Cervical Vertebrae*/surgery, Humans ; Female ; Middle Aged ; Reoperation/methods
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Grant Information:
2023YFC2507703 National Key Research and Development Program of China
Contributed Indexing:
Keywords: atlantoaxial dislocation; basilar invagination; craniovertebral junction anomalies; revision surgery; transoral clivocervical fusion
Entry Date(s):
Date Created: 20251214 Date Completed: 20260113 Latest Revision: 20260115
Update Code:
20260115
PubMed Central ID:
PMC12796978
DOI:
10.1111/os.70212
PMID:
41391843
Database:
MEDLINE

Weitere Informationen

Background: Craniovertebral junction anomalies (CVJAs), including conditions such as basilar invagination and atlantoaxial dislocation, frequently result in progressive neurological deterioration. Traditional surgical approaches-whether anterior, posterior, or combined-may prove inadequate for revision cases characterized by persistent ventral compression. This study evaluates the efficacy of anterior transoral odontoid reduction combined with clivocervical fusion for managing complex CVJAs requiring revision surgery.
Methods: A 56-year-old female patient presented with recurrent symptoms following prior posterior occipitocervical fusion. She underwent revision surgery involving anterior transoral odontoid reduction combined with clivocervical fusion. Postoperative rehabilitation, imaging studies (CT, MRI, and CTA), and neurological function assessed via the JOA score were evaluated at 3-, 6-, and 12-month follow-up intervals.
Results: Postoperative imaging demonstrated significant improvements: the clivo-axial angle improved to 146.1° from 135.5°, the odontoid tip descended caudally by 4.33 mm, and spinal cord compression resolved. Neurological function improved, with stable fixation, successful fusion, and no complications. Long-term follow-up confirmed sustained radiographic stability and neurological recovery.
Conclusion: Anterior transoral odontoid reduction combined with clivocervical fusion effectively addresses persistent ventral compression in revision CVJAs cases. This technique achieves neural decompression, biomechanical stability, and functional recovery, offering a promising option for complex cases with failed initial posterior fixation.
(© 2025 The Author(s). Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd.)