Minimally invasive surgical therapy for Kimmerle anomaly.
J Craniovertebr Junction Backbone. 2017 Oct-Dec;eight(four):359-363
Authors: Lvov I, Lukianchikov V, Grin A, Sytnik A, Polunina N, Krylov V
Summary
Introduction: Kimmerle anomaly is the bony ridge between the lateral mass of atlas and its posterior arch or transverse course of. This bony tunnel might embrace the V3 section of the vertebral artery, vertebral vein, posterior department of the C1 spinal nerve, and the sympathetic nerves, which leads to the medical signs of this illness. Experiences on the surgical therapy of Kimmerle anomaly are uncommon. There aren’t any experiences on minimally invasive surgical therapy of this pathology.
Supplies and Strategies: Six sufferers with Kimmerle anomaly had been handled from 2015 till 2016. Three sufferers underwent routine surgical procedure by the posterior midline (posterior midline strategy [PMA] group). The opposite three sufferers underwent decompression with a paravertebral transmuscular strategy (PTMA group). The operation time, intraoperative blood loss, medical signs earlier than and after surgical procedure in addition to intra- and post-operative problems had been in contrast between the PTMA and PMA teams.
Outcomes: The outcomes of the surgical therapies had been assessed at discharge and 1 12 months later. Blood loss, operation time, and depth of ache on the postoperative wound space had been decrease within the PTMA group. There have been no postoperative problems. The delayed surgical therapy outcomes didn’t rely on the strategy of artery decompression.
Conclusions: Surgical therapy of vertebral artery compression in sufferers with Kimmerle anomaly is preferable in circumstances the place conservative therapy is inefficient. A minimally invasive PTMA is an alternative choice to the routine midline posterior strategy, offering direct visualization of the compressed V3 section of the vertebral artery and minimizing postoperative ache.
PMID: 29403250 [PubMed]