ReviewActa neurochirurgica2020
Chiari malformation type I and basilar invagination originating from atlantoaxial instability: a literature review and critical analysis.
Review in Acta neurochirurgica, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Surgical failures and revision strategies in Basilar invagination: an exploratory analysis of 145 published cases.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Pooled it
- The management of Chiari malformation type 1 and syringomyelia in children: a review of the literature.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2021Pooled it
- Pediatric complex Chiari I Malformation-how complex is it?Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Article
- Anterior Transoral Odontoid Reduction With Clivocervical Fusion in Revision Surgery for Craniovertebral Junction Anomalies: A Case Report and Technical Note.Orthopaedic surgery · 2026Article
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- Surgical outcomes of basilar invagination type B without atlantoaxial dislocation through simple posterior fossa decompression: a retrospective study of 18 cases.Acta neurochirurgica · 2023Article
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- Chiari Type 1 Malformation and Syringomyelia in Children: Classification and Treatment Options.Advances and technical standards in neurosurgery · 2023Review
- Chiari Malformation Type 1 and Syringomyelia: Why Do Patients Claim for International Guidelines? Commentary on the 2021 Chiari and Syringomyelia Consensus Document.Acta neurochirurgica. Supplement · 2023Article
- Occipital condyle screw fixation after posterior decompression for Chiari malformation: Technical report and application.Surgical neurology international · 2021Article
- Predictors of reoperation for spinal disorders in Chiari malformation patients with prior surgical decompression.Journal of craniovertebral junction & spineArticle
- Intermittent and Unilateral Chorioretinal Folds due to Combined Chiari 1 Malformation and Basilar Invagination.Case reports in ophthalmologyArticle
- Intraoperative occipital to C2 angle and external acoustic meatus-to-axis angular measurements for optimizing alignment during posterior fossa decompression and occipitocervical fusion for complex Chiari malformation.Journal of craniovertebral junction & spineArticle
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7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionRecently, a novel hypothesis has been proposed concerning the origin of craniovertebral junction (CVJ) abnormalities. Commonly found in patients with these entities, atlantoaxial instability has been suspected to cause both Chiari malformation type I and basilar invagination, which renders the tried and tested surgical decompression strategy ineffective. In turn, C1-2 fusion is proposed as a single solution for all CVJ abnormalities, and a revised definition of atlantoaxial instability sees patients both with and without radiographic evidence of instability undergo fusion, instead relying on the intraoperative assessment of the atlantoaxial joints to confirm instability.
methodsThe authors conducted a comprehensive narrative review of literature and evidence covering this recently emerged hypothesis. The proposed pathomechanisms are discussed and contextualized with published literature.
conclusionThe existing evidence is evaluated for supporting or opposing sole posterior C1-2 fusion in patients with CVJ abnormalities and compared with reported outcomes for conventional surgical strategies such as posterior fossa decompression, occipitocervical fusion, and anterior decompression. At present, there is insufficient evidence supporting the hypothesis of atlantoaxial instability being the common progenitor for CVJ abnormalities. Abolishing tried and tested surgical procedures in favor of a single universal approach would thus be unwarranted.
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