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Journal of Craniovertebral Junction and Spine
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CASE REPORT
Year : 2018  |  Volume : 9  |  Issue : 3  |  Page : 212-215

Basilar impression in osteogenesis imperfecta treated with staged halo traction and posterior decompression with short-segment fusion


1 Department of Orthopaedics, Nemours/Alfred I. Dupont Hospital for Children, Wilmington, Delaware, USA; Department of Orthopedics and Traumatology, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey
2 Department of Orthopaedics, University of Washington, Seattle Children's Hospital, Seattle WA, USA
3 Department of Neurosurgery, Nemours/Alfred I. Dupont Hospital for Children, Wilmington, Delaware, USA
4 Department of Orthopaedics, Nemours/Alfred I. Dupont Hospital for Children, Wilmington, Delaware, USA

Correspondence Address:
Dr. Suken A Shah
Department of Orthopaedics, Nemours/Alfred I. Dupont Hospital for Children, 1600, Rockland Rd, Wilmington, DE 19803
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcvjs.JCVJS_63_18

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Basilar impression is a cranial base abnormality associated with osteogenesis imperfecta (OI) with serious neurologic implications but controversial treatment options. Combined anterior and posterior decompression with long-segment posterior fusion is often recommended. We report a patient with OI (Sillence type III) with basilar impression treated with halo traction followed by posterior surgery. The patient was a 12-year-old female with a presentation of hiccups and change in upper extremity function. Diagnostic imaging revealed syringomyelia, compensated hydrocephalus, basilar impression, and Chiari type I malformation. The patient was treated with halo traction followed by posterior decompression fusion from the occipital bone to C2. Bone fusion and improved syrinx were evident on images during the 5 years of follow-up. Five years after surgery, syrinx recurred and the fourth ventricular catheter was revised. The treatment with halo traction followed by posterior-only surgery of basilar impression associated with OI resulted in a good postoperative outcome.


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