Invaginación basilar no asociada a Síndrome de Chiari y compresión crítica de unión bulbomedular: Revisión bibliográfica y técnica quirúrgica en un caso clínico

Abstract

Introduction: Basilar invagination is a complex malformation of the cervicalcranial junction where tratment consensus has not been reached and the therapeutic approach must be individualized depending on the case and the associated anatomical variants. In the most severe cases, an adecuate therapeutic approach could determine significant or total regression of neurological symptoms, arrive at the analysis of the treatment algorithms based on an adecuate understanding of the anatomy, anatomycal variants and conceptualization as close as possible to the most correct diagnosis for the application of the best treatment method. Methods: A literature review of the main existing works on malformations of the craniocervical junction was made, placing emphasis on anatomical and morphological diagnosis, biomechanics and physiology and radiological findings. Conclusion: The adequate conceptualization and classification of the pathology allows to take as a reference framework for the treatment with the algorithms proposed by Goel and Sonntag. However, each patient has individual characteristics and the concept in itself constitutes a continuum of malformations that must be resolved by different surgical routes, in diferent times if necessary and supported by different currentsuport technologies such as neuronavigation and trans  europhysiological monitoring operative.