Nasoseptal flap revision in endoscopic endonasal odontoidectomy for acute atlantoaxial osteomyelitis with atlantoaxial subluxation
Vertebral osteomyelitis compromises approximately 1%–7% of all cases of osteomyelitis, whereas the cervical region is affected in 3%–10% of all cases. Not surprisingly, osteomyelitis at the craniocervical junction is a rare occurrence that poses certain challenge to surgeons. With the advancement of...
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| Autor*in: |
Chien-Lun Tang [verfasserIn] Chiung-Chyi Shen [verfasserIn] |
|---|
| Format: |
E-Artikel |
|---|---|
| Sprache: |
Englisch |
| Erschienen: |
2021 |
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| Schlagwörter: |
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| Übergeordnetes Werk: |
In: Formosan Journal of Surgery - Wolters Kluwer Medknow Publications, 2017, 54(2021), 4, Seite 159-163 |
|---|---|
| Übergeordnetes Werk: |
volume:54 ; year:2021 ; number:4 ; pages:159-163 |
| Links: |
|---|
| DOI / URN: |
10.4103/fjs.fjs_115_20 |
|---|
| Katalog-ID: |
DOAJ076653692 |
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10.4103/fjs.fjs_115_20 doi (DE-627)DOAJ076653692 (DE-599)DOAJ6362b0ab7ade41faab86b5434e262364 DE-627 ger DE-627 rakwb eng RD1-811 Chien-Lun Tang verfasserin aut Nasoseptal flap revision in endoscopic endonasal odontoidectomy for acute atlantoaxial osteomyelitis with atlantoaxial subluxation 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Vertebral osteomyelitis compromises approximately 1%–7% of all cases of osteomyelitis, whereas the cervical region is affected in 3%–10% of all cases. Not surprisingly, osteomyelitis at the craniocervical junction is a rare occurrence that poses certain challenge to surgeons. With the advancement of antibiotics, most patients with vertebral osteomyelitis can be successfully treated by conservative treatment. However, surgical intervention is indicated in cases presented with neurological deficits, spinal deformity, or instability. We present one case of retropharyngeal abscess involving the craniocervical junction that led to irreducible atlantoaxial rotatory dislocation and significant ventral cord compression. Staged procedures with endoscopic endonasal odontoidectomy assisted by nasoseptal flap reconstruction for decompression and posterior occipitocervical fusion were arranged in sequence. Nevertheless, postoperative magnetic resonance imaging revealed incomplete decompression at C2 level of the cervical spine. Prompt revision surgery with nasoseptal flap takedown and reuse performed uneventfully. The patient recovered well and was able to ambulate 5 weeks later. This case illustrated long-term radionecrosis complicated with osteomyelitis and craniocervical instability. An aggressive surgical decompression followed by staged spinal fusion would be beneficial in such complex osteomyelitis cases. nasoseptal flap odontoidectomy osteomyelitis Surgery Chiung-Chyi Shen verfasserin aut In Formosan Journal of Surgery Wolters Kluwer Medknow Publications, 2017 54(2021), 4, Seite 159-163 (DE-627)683365509 (DE-600)2645317-4 22135413 nnns volume:54 year:2021 number:4 pages:159-163 https://doi.org/10.4103/fjs.fjs_115_20 kostenfrei https://doaj.org/article/6362b0ab7ade41faab86b5434e262364 kostenfrei http://www.e-fjs.org/article.asp?issn=1682-606X;year=2021;volume=54;issue=4;spage=159;epage=163;aulast=Tang kostenfrei https://doaj.org/toc/1682-606X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_100 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2055 GBV_ILN_2111 AR 54 2021 4 159-163 |
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10.4103/fjs.fjs_115_20 doi (DE-627)DOAJ076653692 (DE-599)DOAJ6362b0ab7ade41faab86b5434e262364 DE-627 ger DE-627 rakwb eng RD1-811 Chien-Lun Tang verfasserin aut Nasoseptal flap revision in endoscopic endonasal odontoidectomy for acute atlantoaxial osteomyelitis with atlantoaxial subluxation 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Vertebral osteomyelitis compromises approximately 1%–7% of all cases of osteomyelitis, whereas the cervical region is affected in 3%–10% of all cases. Not surprisingly, osteomyelitis at the craniocervical junction is a rare occurrence that poses certain challenge to surgeons. With the advancement of antibiotics, most patients with vertebral osteomyelitis can be successfully treated by conservative treatment. However, surgical intervention is indicated in cases presented with neurological deficits, spinal deformity, or instability. We present one case of retropharyngeal abscess involving the craniocervical junction that led to irreducible atlantoaxial rotatory dislocation and significant ventral cord compression. Staged procedures with endoscopic endonasal odontoidectomy assisted by nasoseptal flap reconstruction for decompression and posterior occipitocervical fusion were arranged in sequence. Nevertheless, postoperative magnetic resonance imaging revealed incomplete decompression at C2 level of the cervical spine. Prompt revision surgery with nasoseptal flap takedown and reuse performed uneventfully. The patient recovered well and was able to ambulate 5 weeks later. This case illustrated long-term radionecrosis complicated with osteomyelitis and craniocervical instability. An aggressive surgical decompression followed by staged spinal fusion would be beneficial in such complex osteomyelitis cases. nasoseptal flap odontoidectomy osteomyelitis Surgery Chiung-Chyi Shen verfasserin aut In Formosan Journal of Surgery Wolters Kluwer Medknow Publications, 2017 54(2021), 4, Seite 159-163 (DE-627)683365509 (DE-600)2645317-4 22135413 nnns volume:54 year:2021 number:4 pages:159-163 https://doi.org/10.4103/fjs.fjs_115_20 kostenfrei https://doaj.org/article/6362b0ab7ade41faab86b5434e262364 kostenfrei http://www.e-fjs.org/article.asp?issn=1682-606X;year=2021;volume=54;issue=4;spage=159;epage=163;aulast=Tang kostenfrei https://doaj.org/toc/1682-606X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_100 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2055 GBV_ILN_2111 AR 54 2021 4 159-163 |
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Nasoseptal flap revision in endoscopic endonasal odontoidectomy for acute atlantoaxial osteomyelitis with atlantoaxial subluxation |
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Nasoseptal flap revision in endoscopic endonasal odontoidectomy for acute atlantoaxial osteomyelitis with atlantoaxial subluxation |
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Chien-Lun Tang |
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Chien-Lun Tang Chiung-Chyi Shen |
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nasoseptal flap revision in endoscopic endonasal odontoidectomy for acute atlantoaxial osteomyelitis with atlantoaxial subluxation |
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Nasoseptal flap revision in endoscopic endonasal odontoidectomy for acute atlantoaxial osteomyelitis with atlantoaxial subluxation |
| abstract |
Vertebral osteomyelitis compromises approximately 1%–7% of all cases of osteomyelitis, whereas the cervical region is affected in 3%–10% of all cases. Not surprisingly, osteomyelitis at the craniocervical junction is a rare occurrence that poses certain challenge to surgeons. With the advancement of antibiotics, most patients with vertebral osteomyelitis can be successfully treated by conservative treatment. However, surgical intervention is indicated in cases presented with neurological deficits, spinal deformity, or instability. We present one case of retropharyngeal abscess involving the craniocervical junction that led to irreducible atlantoaxial rotatory dislocation and significant ventral cord compression. Staged procedures with endoscopic endonasal odontoidectomy assisted by nasoseptal flap reconstruction for decompression and posterior occipitocervical fusion were arranged in sequence. Nevertheless, postoperative magnetic resonance imaging revealed incomplete decompression at C2 level of the cervical spine. Prompt revision surgery with nasoseptal flap takedown and reuse performed uneventfully. The patient recovered well and was able to ambulate 5 weeks later. This case illustrated long-term radionecrosis complicated with osteomyelitis and craniocervical instability. An aggressive surgical decompression followed by staged spinal fusion would be beneficial in such complex osteomyelitis cases. |
| abstractGer |
Vertebral osteomyelitis compromises approximately 1%–7% of all cases of osteomyelitis, whereas the cervical region is affected in 3%–10% of all cases. Not surprisingly, osteomyelitis at the craniocervical junction is a rare occurrence that poses certain challenge to surgeons. With the advancement of antibiotics, most patients with vertebral osteomyelitis can be successfully treated by conservative treatment. However, surgical intervention is indicated in cases presented with neurological deficits, spinal deformity, or instability. We present one case of retropharyngeal abscess involving the craniocervical junction that led to irreducible atlantoaxial rotatory dislocation and significant ventral cord compression. Staged procedures with endoscopic endonasal odontoidectomy assisted by nasoseptal flap reconstruction for decompression and posterior occipitocervical fusion were arranged in sequence. Nevertheless, postoperative magnetic resonance imaging revealed incomplete decompression at C2 level of the cervical spine. Prompt revision surgery with nasoseptal flap takedown and reuse performed uneventfully. The patient recovered well and was able to ambulate 5 weeks later. This case illustrated long-term radionecrosis complicated with osteomyelitis and craniocervical instability. An aggressive surgical decompression followed by staged spinal fusion would be beneficial in such complex osteomyelitis cases. |
| abstract_unstemmed |
Vertebral osteomyelitis compromises approximately 1%–7% of all cases of osteomyelitis, whereas the cervical region is affected in 3%–10% of all cases. Not surprisingly, osteomyelitis at the craniocervical junction is a rare occurrence that poses certain challenge to surgeons. With the advancement of antibiotics, most patients with vertebral osteomyelitis can be successfully treated by conservative treatment. However, surgical intervention is indicated in cases presented with neurological deficits, spinal deformity, or instability. We present one case of retropharyngeal abscess involving the craniocervical junction that led to irreducible atlantoaxial rotatory dislocation and significant ventral cord compression. Staged procedures with endoscopic endonasal odontoidectomy assisted by nasoseptal flap reconstruction for decompression and posterior occipitocervical fusion were arranged in sequence. Nevertheless, postoperative magnetic resonance imaging revealed incomplete decompression at C2 level of the cervical spine. Prompt revision surgery with nasoseptal flap takedown and reuse performed uneventfully. The patient recovered well and was able to ambulate 5 weeks later. This case illustrated long-term radionecrosis complicated with osteomyelitis and craniocervical instability. An aggressive surgical decompression followed by staged spinal fusion would be beneficial in such complex osteomyelitis cases. |
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Nasoseptal flap revision in endoscopic endonasal odontoidectomy for acute atlantoaxial osteomyelitis with atlantoaxial subluxation |
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