Affiliation:
1. Department of Neurosurgery, Istanbul Faculty of Medicine Istanbul University Istanbul Turkey
2. Department of Neurosurgery, Istanbul Scoliosis and Spine Center Florence Nightingale Hospital Istanbul Turkey
3. Center for Spine Surgery and Pain Therapy, Center for Orthopedics and Traumatology of the St. Elisabeth Group‐Catholic Hospitals Rhein‐Ruhr St. Anna Hospital Herne/Marien Hospital Herne University Hospital/Marien Hospital Witten Herne Germany
Abstract
AbstractAlthough endoscope‐assisted techniques have been described, a full‐endoscopic approach is yet to be performed for posterior fossa decompression (PFD) in Chiari malformation type I (CM‐I). This study aims to describe the full‐endoscopic PFD technique and evaluate its feasibility. Five fresh‐frozen anonymized adult human cadavers were operated on using an endoscope with an oval shaft cross‐section with a diameter of 9.3 mm, a working length of 177 mm, and a viewing angle of 20°. It also had an eccentric working channel with a diameter of 5.6 mm, a light guide, a sheath for continuous irrigation, and a rod lens system. The instruments were introduced from the working channel. Posterior craniocervical structures were dissected, and PFD was achieved. The planned steps were performed in all five cadavers. The endoscope was introduced to the posterior craniocervical region, dissecting the structures to easily expose the suboccipital bone and C1 posterior arch. Important structures, such as the C1 posterior tubercle, rectus capitis posterior minor muscles, and posterior atlantooccipital membrane, were used as landmarks. PFD was feasible even with the dural opening. Using the full‐endoscopic approach, posterior craniocervical structures can be reached, and PFD can be performed successfully. The instruments used are well‐defined for spinal usage; thus, this full‐endoscopic technique can be widely used in the surgical treatment of patients with CM‐I.
Subject
General Medicine,Histology,Anatomy
Cited by
2 articles.
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