Occipital neck hinge deformity surgery

Occipital neck hinge malformation is a congenital malformation, characteristic in the abnormalities of the brain in the occipital position of the neck. This type of malformations are often treated surgically. The purpose of occipital neck hinge deformity surgery is to alleviate the symptoms of the disease or prevent the progress of spinal cord hollowness.

1. Overview of occipital neck hinge malformation

1.1 What is occipital neck hinge deformity?

Occipital neck hinge malformation is also known as occipital neck malformation, Chiari Malformation is considered a rare birth defect (rate less than 0.1%). This is a condition where abnormal brain problems occur in the occipital position of the neck characterized by the low downward movement of the cerebral almonds through the occipital hole. Most cases of occipital neck hinge malformation are asymptomatous. The disease is often detected by chance thanks to imaging in patients experiencing other health problems.

1.2 Classification of Chiari malformation

  • Type I Chiari deformity

This type of malformation occurs during fetal development, characterized by the condition of the cerebral almonds moving more than 4mm below the occipital hole into the cervical spine. This movement prevents the normal circulation of cerebral fluid between the spinal canal and the inverted space.

Patients with Type 1 Chiari deformities are more likely to experience abnormalities in the base of the skull and spine such as:

  • Squeezing the upper spine into the base of the skull causes compression of the brain body;
  • Sticking the first cervical vertebrae to the base of the skull;
  • Stick part of the 1st and 2nd cervical vertebrae;
  • Klippel – Feil deformation (congenital stickiness of the cervical vertebrae);
  • Cracking of the hidden vertebrae;
  • Scoliosis.

Many patients with Type I Chiari deformity are asymptomatous. Others have some symptoms associated with the development of the pulp canal such as: Headache, severe neck; occipital headache, more painful sensation when coughing, sneezing or stress; weakness of arms and arms; loss of pain sensation and temperature sensation of the upper body, arms; collapse due to muscle weakness; dizziness; paralysis; have balance problems; double vision or blurry vision; hypersensitivity to glare.

  • Type II Chiari Deformity

This type of malformation is almost only seen in patients with myeloid hernias – myeloid membranes, characterized by the downward movement of the myeloid, cerebral and fourth erthinal onions into the cervical spinal canal, the elongation of the cerebral bridge and the atatheterular brain.

Symptoms of type II occipital neck hinge malformation are: Changes in breathing, vomiting, weakness of the arms, down movement of the eyes in an unsusing way.

  • Type III Chiari deformity

This deformity includes spinal congenital malformations, a part hernia of the primary brain and/or brain on the back of the head or neck. This is a rare malformation, which has a very high premature mortality rate or causes severe neurological disorders in surviving patients.

  • Type IV Chiari Deformity

It is the most severe and rare type of occipital hinge malformation, characterized by a condition in which the small brain does not develop normally, there may be other deformities in the brain and brain trunk. Most babies born with Type IV Chiari deformities die prematurely.

Symptoms of Type IV Chiari Malformation are: Scoliosis; weakness and muscle spasms; loss of sensation, especially the feeling of heat – cold; motor deterioration; loss of control of the intestines and bladder; chronic pain; headache.

1.3 Diagnosis of occipital neck hinge malformation

Several methods help diagnose and determine the degree of Chiari deformity:

  • Cerebral auditory conductive recording helps to check the integrity of the auditory conductive system, used to determine if the brain body is functioning well;
  • Myeloid scan: Is an X-ray technique of the spinal canal after injecting a phototholynthever into the lumbar fluid. The method of poking the pulp allows the doctor to observe the image of compression on the spinal cord or nerves due to occipital neck hinge malformation;
  • Computer ctectence: Using X-rays for diagnosis, which helps determine the size of the brain, displays obstruction. However, this technique is less effective in analyzing the back pit or spinal cord;
  • Resonance imaging: Use strong from fields and computer technology to create 3D images of body structure. This technique provides accurate images of the brain, cerebrospinal cord and spinal cord, thereby helping the doctor to clearly determine the degree of Chiari malformation, distinguishing the progress;
  • Physical sensation-evocative potential recording: Is a method of recording the electrical activity of the nerves associated with sensation, providing some information about the peripheral nerve, brain function and spinal cord.

Resym resonance imaging

Rem resonance imaging helps diagnose occipital neck hinge malformation

1.4 Treatment of Chiari deformity

Treatment of occipital neck hinge malformation depends on the type of malformation, the progress in anoperative changes or symptoms of the disease. With asymptoatic Chiari type I malformation should be treated conservatively. If the deformity is symptomatic or causes a spinal cord emptying, surgery is usually recommended. Type II Chiari malformation is treated surgically if the patient has symptoms and determines there are no hydrocephalus complications. The purpose of surgery to treat occipital neck hinge malformation is to optimally suppress nerve tissue and regenerate normal cbrospinal fluid flow around and after the primary brain.

2. Details of occipital neck hinge deformity surgery

2.1 Contrain specify/contrain specify

Specify

Chiari I malformation with clinical manifestations

Contrainatrained

  • The patient cannot be anesthetic;
  • Patients with diseases of blood clot disorders.

Blood clot disorders

Patients with blood clot disorders are not prescribed surgery

2.2 Preparation

  • Personnel performed: Neurosurgen, anesthesisisi, assistant,…;
  • Facilities: Cranial surgical kits, machine drills, cranial drills, specialized microsurgery glasses for neurosurgery, fixed pins of skull bones, artificial patches, bio-glue, hemorrnoids,…;
  • Patients: Being examined for the diagnosis of Chiari deformity, examination of coordinated diseases and related diseases, sharing information about the purpose of surgery, the process of implementation; evening fasting before surgery; take some additional drugs as prescribed;
  • Medical records: Complete according to the general medical record form.

2.3 Surgical procedures

  • Position: The patient lies on the head fixed on the frame;
  • Insymity: Insymed anesthesia;
  • Incision of the skin in a straight, central line corresponding to the occipital hole;
  • Opening the back pit skull bone and occipital neck hinges: The size from the occipital hole to 3cm, from the middle line to the sides is at least 1.5cm;
  • Post-cervical arcecting first;
  • Open the sural in an inverted Y-shape and try to preserve the arachnoid membrane;
  • Perform sural forming;
  • Close the sural membranes and incisions according to the layers of anatomy. Before closing the final stitch should pump water filled the cavity in the sural to expuls gas and detect bleeding if any.

2.4 Post-surgery monitoring and accident handling

Patients are monitored within 24 hours of surgery at the neurosurgery department to promptly detect surgical-related accidents.

  • Monitor survival indicators: Blood pressure, respiration, pulse, temperature,…;
  • Use of backup antibiotics, analgesies;
  • Monitor for local neurological signs and early detection of complications;
  • Handling of post-surgery bleeding: Early detection when clinical signs are present, com computer ctecting is required to check if necessary and when in vicranial hematoma is required to be treated early according to the lesion;
  • Dealing with lumbar fluid leakage: Stitch up the incision or re-peck to patch the fistula;
  • Dealing with incision infections: Take antibiotics, change bandages daily or clean the outbreak;
  • Patients should return early from the 2nd day after surgery if possible to avoid complications due to long lying. Patients may also wear soft neck braces a few weeks after surgery.

Hypotension

After the surgery, patients are carefully monitored blood pressure, temperature

After surgery of occipital neck hinge deformity, the patient's tentative is usually quite good. In order to increase the chances of treatment from the disease and reduce the risk of accidents during and after surgery, patients need to strictly follow the doctor's regulations when performing surgery.

Share99 International Health Hub with a system of modern facilities, medical equipment and a team of experts and doctors with many years of experience in neurological examination and treatment, patients can be assured of examination and treatment at the Health Hub.

To register for examination and treatment at Share99 International Health Hub, you can contact Share99 Health System nationwide, or register for an online examination HERE.

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About: John Smith

b1ffdb54307529964874ff53a5c5de33?s=90&r=gI am the author of Share99.net. I had been working in Vinmec International General Hospital for over 10 years. I dedicate my passion on every post in this site.

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