Analysis of Failed Posterior Fossa Decompression and an Effective Revision Surgery in Patients with Basilar Invagination and Atlantoaxial Dislocation

Basilar invagination (BI) is a bone malformation at the junction of the skull and spine, often linked to other conditions. There are two types, one needing surgery to stabilize the neck and the other needing posterior fossa decompression (PFD). Sometimes, PFD alone isn't enough, especially when there's also atlantoaxial dislocation (BI-AAD). This can worsen the dislocation, requiring revision surgery. The study introduces a posterior revision surgery technique. The new surgical technique involves releasing tension through interarticular distraction, using cage grafting with bone, and fixing the area. This method aims to improve stability and fusion, leading to better outcomes.

• 1
  The revision surgery significantly improved the JOA and SF-12 scores one year after the operation, indicating better clinical symptoms and health status.
• 2
  Postoperative imaging confirmed effective reduction of compression related to BI-AAD without implant failure or neurovascular injury.
• 3
  All patients showed evidence of bone fusion within a 12-month follow-up period, confirming the stability of the surgical technique.