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Figure 1: A 9-year-old child presented to us with progressive spastic quadriparesis (Nurick grade IV) and the CT (A) sagittal image showed AAD with basilar invagination. There was severe canal compromise at foramen magnum and posterior arch of atlas was occipitalized. We did transoral odontoidectomy followed by posterior fixation (O-C1-C2). The postoperative (B) axial and (C) sagittal CT-scan shows ventral decompression and adequate funneling of craniovertebral junction. The child improved in postoperative period and after a follow-up of 3-years, the patient is able to walk without support

Figure 1: A 9-year-old child presented to us with progressive spastic quadriparesis (Nurick grade IV) and the CT (A) sagittal image showed AAD with basilar invagination. There was severe canal compromise at foramen magnum and posterior arch of atlas was occipitalized. We did transoral odontoidectomy followed by posterior fixation (O-C1-C2). The postoperative (B) axial and (C) sagittal CT-scan shows ventral decompression and adequate funneling of craniovertebral junction. The child improved in postoperative period and after a follow-up of 3-years, the patient is able to walk without support