Cranio-vertebral junction anomalies with Atlanto-axial instability: Management and complications- Our experience of 63 cases at a tertiary care center in India

IntroductionManagement of complex cranio-vertebral junction anomalies with atlanto-axial instability require extensive pre-operative work up with various intra-operative (and/orpreoperative)manouvres and bony fusion procedures and post-operative rehabilitation and support. This study focuses on various management strategies in terms of its outcome and complications. Materials and methodology:This clinical analytical study shares our experience of 63 cases of cvjunction anomalies with atlanto-axial instability operated at tertiary care center in india. 63 patientsoperated during the period spanning from June-2019 to November-2021 who had atlanto axial instability (AAD WITH/WITHOUT BI). Patients were assessed pre-operatively and post-operativelyup to 3 months objectively and subjectively in terms of outcome and post op radiology was also done. Results:Out of 63 atlanto-axial operated patients, 42 improved, 3 had stable disease and 12deteriorated clinically some of whom required also secondary procedures for it. Out of 63 ,8 patientshad died,4 of them were pediatric and 4 were adults. Various procedure related complicationsoccurred in 12 patients. Conclusion: Thus, with proper pre-operative diagnosis of type of congenital anomaly combined with appropriate surgical plan can give impacting results in these pathologies withminimal complications.