Background: Little attention has been given to the retroverted dens within the existing medical literature. However, this finding can have a clinical impact, especially in patients with Chiari malformation type I (CM1), as it can have consequences for further treatment.
Methods: Using standard search engines, we performed a literature review of anatomical, radiologic, and clinical studies as well as pathologic and surgical considerations related to the retroverted dens. Key words for our search included retroverted dens; retroflexed dens; odontoid retroflexion; posterior inclination; and tilted dens.
Results: A retroverted dens is most commonly found in the pediatric population in relation to CM1. Research has demonstrated that high degree of dens angulation can result in significant anterior brain stem compression with the need for both anterior and posterior decompression in patients with symptomatic CM1.
Conclusions: A greater degree of dens angulation can lead to neurologic symptoms secondary to spinomedullary compression. Therefore, correct measurements are essential as such findings can influence presurgical planning.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.wneu.2020.01.231 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Retroflexed dens in paediatric Chiari 1 patients and implications: Single centre retrospective study.
Childs Nerv Syst
May 2024
Department of Neurosurgery, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK.
Introduction: Chiari 1 malformation and hind brain hernia can be associated with skull base and craniocervical anomalies. One of the more recently associated anomalies is a retroverted or retroflexed odontoid process or dens. We conducted a retrospective study of our operated symptomatic and conservatively managed asymptomatic Chiari cohort to assess the impact of dens retroflexion on rate of revision or cerebrospinal fluid diversion following primary foramen magnum decompression (FMD).
View Article and Find Full Text PDFThe Retroverted Dens: A Review of its Anatomy, Terminology, and Clinical Significance.
World Neurosurg
May 2020
Department of Anatomical Sciences, St. George's University, St. George's, Grenada; Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA; Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA; Department of Neurosurgery, Ochsner Health System, New Orleans, Louisiana, USA.
Background: Little attention has been given to the retroverted dens within the existing medical literature. However, this finding can have a clinical impact, especially in patients with Chiari malformation type I (CM1), as it can have consequences for further treatment.
Methods: Using standard search engines, we performed a literature review of anatomical, radiologic, and clinical studies as well as pathologic and surgical considerations related to the retroverted dens.
Simultaneous odontoid excision with bilateral posterior C1-2 distraction and stabilization utilizing bilateral posterolateral corridors and a single posterior midline incision.
Neurol India
July 2019
Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
A simultaneous odontoid decompression and bilateral posterior atlanto-axial facetal distraction, C1-2 joint spacer/bone graft placement and stabilization may be performed utilizing the 'posterior-only' approach. This procedure may be performed utilizing a single posterior midline incision, a bilateral posterior approach to the C1-2 facet joints and a bilateral posterolateral approach to the odontoid process and C2 body. It may be carried out in situations where a C1-2 non-reduction/partial reduction using a 'posterior alone' procedure is anticipated due to the complex bony/soft tissue configuration anterior at the thecal sac existing at the cervicomedullary junction.
View Article and Find Full Text PDFVentral compression in adult patients with Chiari 1 malformation sans basilar invagination: cause and management.
Acta Neurochir (Wien)
January 2012
Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Background: A small subset of patients with adult Chiari I malformation without basilar invagination (BI) and instability show ventral cervicomedullary distortion/compression and have symptoms pertaining to that. The cause of this ventral compression remains speculative. Additionally, it is unclear if these patients would require ventral decompression with posterior fusion or only posterior decompression would suffice.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!