Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct 13;7(2):183-187.
doi: 10.22603/ssrr.2022-0093. eCollection 2023 Mar 27.

Transoral Surgery for Irreducible Atlantoaxial Dislocation Complicated by Concomitant Aberrant Internal Carotid Arteries

Kazuhiro Inomata  1 , Eiji Takasawa  1 , Yoshitaka Matsubayashi  2 , Yukihiro Takayasu  3 , Fumiaki Honda  4 , Masaru Tobe  5 , Sho Ishiwata  1 , Yohei Kakuta  1 , Yusuke Tomomatsu  1 , Akira Honda  1 , Shunsuke Ito  1 , Tokue Mieda  1 , Yoichi Iizuka  1 , Hirotaka Chikuda  1
Affiliations

Transoral Surgery for Irreducible Atlantoaxial Dislocation Complicated by Concomitant Aberrant Internal Carotid Arteries

Kazuhiro Inomata et al. Spine Surg Relat Res. .
No abstract available

Keywords: cervical spine; craniovertebral junction; irreducible atlantoaxial dislocation; myelopathy; surgery; transoral approach.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors declare that there are no relevant conflicts of interest.

Figures

Figure 1.
Figure 1.
Postoperative images. X-rays and computed tomography (CT) showed the upper cervical anomaly of the occipito-atlantal junction and C2-C3 assimilation with basilar invagination of the odontoid process (A, B, D). Magnetic resonance imaging showed Chiari type 1 malformation and compression of the medulla and upper cervical cord (C). CT angiography showed the aberrant internal carotid arteries through the atlantoaxial segment (E).
Figure 2.
Figure 2.
Setting prior to the second surgery. The soft palate was fished out using a nelaton catheter inserted through the nasal cavity, and the pharynx was expanded using retractors. The reference arc for intraoperative navigation was attached to the halo crown using a connector (bold arrow).
Figure 3.
Figure 3.
Transoral carotid ultrasonography with color Doppler. Color Doppler ultrasonography showed that the right internal jugular vein and internal carotid artery ran through the C1 anterior arch. The probe was placed at the yellow dotted line. Green areas are safe for incision.
Figure 4.
Figure 4.
Postoperative images. The irreducible atlantoaxial dislocation with basilar invagination was reduced (A), and the spinal cord was decompressed (B) after atlantoaxial anterior release (black dotted line) (C).
See this image and copyright information in PMC

References

    1. Wang C, Yan M, Zhou HT, et al. Open reduction of irreducible atlantoaxial dislocation by transoral anterior atlantoaxial release and posterior internal fixation. Spine. 2006;31(11):E306-13. - PubMed
    1. Koreckij J, Alvi H, Gibly R, et al. Incidence and risk factors of the retropharyngeal carotid artery on cervical magnetic resonance imaging. Spine. 2013;38(2):E109-12. - PubMed
    1. Pfeiffer J, Ridder GJ. A clinical classification system for aberrant internal carotid arteries. Laryngoscope. 2008;118(11):1931-6. - PubMed
    1. Paulsen F, Tillmann B, Christofides C, et al. Curving and looping of the internal carotid artery in relation to the pharynx: frequency, embryology and clinical implications. J Anat. 2000;197Pt 3(Pt 3):373-81. - PMC - PubMed
    1. Marcucci C, Thomas P, Sewell DA. Retropharyngeal carotid artery: an important anatomic variation for the anesthesiologist. Anesthesiology. 2009;111(2):454-5. - PubMed

LinkOut - more resources