Occipitocervical fusion after resection of craniovertebral junction XXXX .

@entity1 @entity511 @entity5 @entity1653 @entity4048 @entity3580 @entity3
OBJECT: Surgical access to @entity5 at the craniovertebral junction (CVJ) requires extensive bone removal. Guidelines for the use of occipitocervical fusion (OCF) after resection of @entity5 have been based on anecdotal evidence. The authors performed a retrospective study of factors associated with the use of OCF in 46 @entity1 with @entity5 . The findings were used to develop recommendations for use of OCF in such @entity1 . METHODS: The authors retrospectively reviewed the cases of 51 @entity1 with @entity5 treated by their group between March 1991 and February 2004. Forty-six @entity1 were available for follow up. Charts were reviewed to obtain data on demographic characteristics, presenting symptoms, and perioperative complications. Preoperative computerized tomography scans and magnetic resonance imaging studies were obtained in all @entity1 . Occipitocervical fusion was performed in @entity1 who had undergone a unilateral condyle resection in which 70% or more of the condyle was removed, a bilateral condyle resection with 50% removal, or C1-2 vertebral body destruction. Of the 46 @entity1 , 16 had foramen magnum @entity1653 , 17 had @entity3580 , one had a @entity511 , two had Schwann cell @entity5 , two had @entity5 , and eight had other types of @entity5 . Twenty-three (50%) of the 46 @entity1 underwent OCF, including 15 of the 17 @entity1 with @entity3580 (88%). None of the @entity1 with @entity1653 required fusion. Seventeen (71%) of the 24 @entity1 presenting with @entity4048 preoperatively underwent OCF. CONCLUSIONS: @entity1 presenting with @entity4048 had a 71% chance of undergoing OCF. @entity1 with @entity3580 and @entity3 were most likely to require OCF. One @entity1 with a 50% unilateral condylar resection returned with OC instability for which OCF was required. Based on their clinical experience and published biomechanical studies, the authors recommend that OCF be performed when 50% or more of one condyle is resected.
