# A Transoral Approach to Decompression Odontoidectomy With Posterior Wiring and Fusion for Pediatric Platybasia With Chiari Malformation

## TL;DR

A seven-year-old girl with a rare skull and spine condition was successfully treated with a transoral surgery and spinal fusion.

## Contribution

This case report highlights a rare pediatric condition and its successful surgical management using a transoral approach.

## Key findings

- A transoral odontoidectomy followed by posterior wiring and fusion successfully treated basilar invagination in a child.
- Dynamic CT and MRI are essential for diagnosing craniovertebral anomalies not visible on standard radiographs.
- Proper diagnosis and management of complex craniovertebral junction deformities require understanding of their anatomy and causes.

## Abstract

Basilar invagination in a Chiari malformation associated with osteogenesis imperfecta in the pediatric population is a rare entity. We report a case of a seven-year-old female who presented with sudden-onset bilateral spastic quadriplegia and evidence of a basilar invagination on MRI. She underwent emergency decompression of the impinging odontoid via transoral approach followed by posterior wiring and fusion of the C1 and C2 vertebrae. Imaging modalities such as dynamic CT and MRI play a major role in delineating any craniovertebral anomalies and neural impingement not easily identified in plain radiographs. Understanding the complex craniovertebral junction (CVJ) anatomy and the possible causes of such deformities is vital for ensuring proper diagnosis and management of these patients.