ENDOSCOPIC TRANS ORAL ODONTOIDECTOMY - A CASE REPORT

The cranioverterbral junction is a collective term that refers to the occiput, atlas, axis and supporting ligaments. A 16 year old presented with difficulty in moving both upper and lower limbs since 2013. Patient was diagnosed as Craniovertebral junction anomaly and underwent Occipito Cervical fusion. He improved after surgery, but being an active boy in growth spurt, he detoriated again and presented with progressive weakness of all four limbs and respiratory difficulty and bladder disturbance since three months. On examination Power in right upper and lower limb was 3 in 5 and Power in left upper and lower limb was 2 in 5. CT scan of cervical spine showed Odontoid process seen compressing the spinal cord.Endoscopic trans oral odontoidectomy was performed under general. Odontoid process was found to be compressing the spinal cord and was reduced with burr and suction apparatus. Post operatively the power in both upper and lower limbs was 4 in 5 with no respiratory and bladder disturbances. Patient post operatively had no complications and he is been on regular follow up without any recurrences.