IMPROVEMENT OF THE SURGICAL APPROACH TO THE TREATMENT OF CRANIOVERTEBRAL JUNCTION ANOMALIES ASSOCIATED WITH SPINAL MALFORMATIONS (CLINICAL EXPERIENCE)

Craniovertebral junction (CVJ) anomalies are complex and rare disorders that require precise diagnostic evaluation and individualized treatment strategies. We report a rare case of Arnold–Chiari II malformation with basilar invagination, secondary hydrocephalus, and closed spinal dysraphism in a pediatric patient. A 12-year-old child presented with severe headaches, motor deficits, and signs of increased intracranial pressure. Imaging revealed Chiari II malformation, basilar invagination, and compensated tethered cord syndrome. Neurophysiological studies indicated compensated spinal dysfunction. The patient underwent posterior C1–C2 fixation with odontoid distraction, resulting in clinical and radiological improvement. This case highlights the importance of tailored neurosurgical approaches in the management of complex CVJ anomalies. Ventral decompression achieved through posterior distraction may obviate the need for additional lumbar intervention, emphasizing the importance of accurate neuroimaging and functional assessment in surgical planning.