Affiliation:
1. N.N. Priorov National Medical Research Center of Traumatology and Orthopaedics
2. N.N. Burdenko National Scientific and Practical Center for Neurosurgery
Abstract
Purpose:to evaluate the efficacy of surgical treatment for the non-tumorous diseases of the craniovertebral region.Patients and Methods. Forty five patients aged 4 – 63 years (mean age 27 years) with non-tumorous diseases of the craniovertebral region were operated on. Either one- or two-step surgical interventions for spinal cord decompression were performed. Early and long term results were evaluated by Frankel, JAO and River scales. In 5 cases the assessment of volumetric craniovertebral interrelationships (VCVI).Results.Good results were obtained in 43 (96%) patients at terms from 1 to 15 years. In 1 patient with mucopolysaccharidoses the aggravation of neurologic symptoms was observed and in 1 case a fatal outcome occurred. VCVI analysis showed a significant improvement of liquor dynamics right up to its normalization in the zone of decompression.Conclusion.Treatment of craniovertebral region diseases requires a differential approach. When necessary to eliminate ventral spinal cord compression it is expedient to perform either transoral or endoscopic transnasal decompression, or transoral spinal cord (myelencephalon) decompression with anterior stabilization by custom-made device (plate).
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