Lesson learned in endoscopic endonasal dens resection for C1-C2 spinal cord decompression.

C1–C2 instability Craniovertebral junction Endoscopic endonasal approach Odontoidectomy Spinal cord decompression

Journal

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
ISSN: 1432-0932
Titre abrégé: Eur Spine J
Pays: Germany
ID NLM: 9301980

Informations de publication

Date de publication:
07 Nov 2023
Historique:
received: 21 11 2022
accepted: 12 10 2023
revised: 01 07 2023
medline: 7 11 2023
pubmed: 7 11 2023
entrez: 7 11 2023
Statut: aheadofprint

Résumé

Endoscopic endonasal approach (EEA) is the safest and most effective technique for odontoidectomy. Nevertheless, this kind of approach is yet not largely widespread. The aim of this study is to share with the scientific community some tips and tricks with our ten-year-old learned experience in endoscopic endonasal odontoidectomy (EEO), which remains a challenging surgical approach. Our case series consists of twenty-one (10 males, 11 females; age range of 34-84 years) retrospectively analyzed patients with ventral spinal cord compression for non-reducible CVJ malformation, treated with EEA from July 2011 to March 2019. The results have recently been reported in a previous paper. The only intraoperative complication observed was intraoperative cerebrospinal fluid (CSF) leak (9.5%), without any sign of post-operative CSF leak. Considering our experience, EEO represents a valid and safe technique to decompress neural cervical structures. Despite its technical complexity, mainly due to the use of endoscope and the challenging surgical area, with this study we encourage the use of EEO displaying our experience-based surgical tips and tricks.

Identifiants

DOI: 10.1007/s00586-023-08001-y PMID: 37934268
pubmed: 37934268
doi: 10.1007/s00586-023-08001-y
pii: 10.1007/s00586-023-08001-y
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2023. The Author(s).

Références

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Auteurs

Irene Portonero (I)

Neurosurgery Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy. irene.portonero@unito.it.
Skull Base Unit, Department of Neuroscience "Rita Levi Montalcini", "Città Della Salute E Della Scienza" University Hospital, University of Turin, Via Cherasco 15, Turin, Italy. irene.portonero@unito.it.
ORCID: 0000-0002-6750-4022

Enrico Lo Bue (E)

Neurosurgery Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy.
Skull Base Unit, Department of Neuroscience "Rita Levi Montalcini", "Città Della Salute E Della Scienza" University Hospital, University of Turin, Via Cherasco 15, Turin, Italy.

Federica Penner (F)

Neurosurgery Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy.
Skull Base Unit, Department of Neuroscience "Rita Levi Montalcini", "Città Della Salute E Della Scienza" University Hospital, University of Turin, Via Cherasco 15, Turin, Italy.

Giuseppe Di Perna (G)

UOC Neurochirurgia, Ospedale SS Annunziata, Tartanto, Italy.

Bianca Maria Baldassarre (BM)

Neurosurgery Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy.
Skull Base Unit, Department of Neuroscience "Rita Levi Montalcini", "Città Della Salute E Della Scienza" University Hospital, University of Turin, Via Cherasco 15, Turin, Italy.
UOC Neurochirurgia, Ospedale SS Annunziata, Tartanto, Italy.

Raffaele De Marco (R)

Neurosurgery Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy.
Skull Base Unit, Department of Neuroscience "Rita Levi Montalcini", "Città Della Salute E Della Scienza" University Hospital, University of Turin, Via Cherasco 15, Turin, Italy.

Alessandro Pesaresi (A)

Neurosurgery Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy.
Skull Base Unit, Department of Neuroscience "Rita Levi Montalcini", "Città Della Salute E Della Scienza" University Hospital, University of Turin, Via Cherasco 15, Turin, Italy.

Diego Garbossa (D)

Neurosurgery Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy.
Skull Base Unit, Department of Neuroscience "Rita Levi Montalcini", "Città Della Salute E Della Scienza" University Hospital, University of Turin, Via Cherasco 15, Turin, Italy.

Giancarlo Pecorari (G)

ENT Surgery Unit, Department of Surgical Sciences, University of Turin, Turin, Italy.

Francesco Zenga (F)

Neurosurgery Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy.
Skull Base Unit, Department of Neuroscience "Rita Levi Montalcini", "Città Della Salute E Della Scienza" University Hospital, University of Turin, Via Cherasco 15, Turin, Italy.

Classifications MeSH