Atlantoaxial Instability with Persistent Second Intersegmental Artery.

Asian journal of neurosurgery Pub Date : 2023-12-29 eCollection Date: 2023-12-01 DOI:10.1055/s-0043-1776050
Batuk Diyora, Ravi Wankhade, Kavin Devani, Anup Purandare, Prakash Palave, Sagar Gawali
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Abstract

Understanding the anatomy of the vertebral artery is essential while manipulating the craniovertebral joint during surgery. Its anomalous course in congenital atlantoaxial dislocation makes it more vulnerable to injury. Preoperative dedicated computed tomography (CT) angiography helps identify the artery's position and plan for surgical procedure. A 13-year-boy presented with neck pain and spastic quadriparesis for 1 year. Radiological imaging of the craniovertebral junction revealed atlantoaxial instability with basilar invagination. His CT angiography of neck and brain vessels revealed an anomalous course of the vertebral artery due to a persistent second intersegment artery. He underwent posterior atlantoaxial fixation after mobilization of the vertebral artery. His clinical condition significantly improved after surgery. We report a case of management of an atlanto axial dislocation with persistent second intersegment artery and describe the role of vertebral artery mobilization during surgery.

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第二节间动脉持续存在的寰枢椎失稳。
在手术过程中操作颅椎关节时,了解椎动脉的解剖结构至关重要。椎动脉在先天性寰枢脱位中的异常走向使其更容易受伤。术前专用的计算机断层扫描(CT)血管造影有助于确定动脉的位置并制定手术计划。一名 13 岁男孩因颈部疼痛和痉挛性四肢瘫痪就诊 1 年。颅椎骨交界处的放射成像显示寰枢椎不稳,基底动脉内陷。颈部和脑血管的 CT 血管造影显示,由于第二节间动脉持续存在,椎动脉走向异常。椎动脉移位后,他接受了后寰枢椎固定术。术后他的临床状况明显改善。我们报告了一例寰枢脱位伴第二节间动脉持续存在的病例,并阐述了椎动脉动员在手术中的作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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