en Spine Case Series <span style="font-size:11pt"><span style="line-height:200%"><span calibri="" style="font-family:"><b><span style="font-size:12.0pt"><span style="line-height:200%"><span new="" roman="" style="font-family:" times="">Background and Importance</span></span></span></b><span style="font-size:12.0pt"><span style="line-height:200%"><span new="" roman="" style="font-family:" times="">:&nbsp; Developmental craniovertebral junction (CVJ) anomalies are often comprised of irreducible atlantoaxial dislocation (AAD) and basilar invagination (BI) associated with the fusion of the C1 arch. BI is described as a congenital upward displacement of mostly the odontoid process into the foramen magnum, which AAD can accompany. The DCER (Distraction, Compression, Extension, and Reduction) consists of decompression of craniocervical junction, BI reduction followed by occipitocervical fusion in anatomic lordotic curvature &ndash;performing extension and compression. This technique has recently been applied in patients with BI and AAD, demonstrating satisfactory results. </span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:200%"><span calibri="" style="font-family:"><b><span style="font-size:12.0pt"><span style="line-height:200%"><span new="" roman="" style="font-family:" times="">Case Presentation:</span></span></span></b><span style="font-size:12.0pt"><span style="line-height:200%"><span new="" roman="" style="font-family:" times=""> Herein, we report two cases of BI with AAD who underwent surgery with the DCER technique for the first time in our center.</span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:200%"><span calibri="" style="font-family:"><b><span style="font-size:12.0pt"><span style="line-height:200%"><span new="" roman="" style="font-family:" times="">Conclusion: </span></span></span></b><span style="font-size:12.0pt"><span style="line-height:200%"><span new="" roman="" style="font-family:" times="">BI has been managed with combined approach (anterior odontoid resection followed by posterior craniocervical fusion). Since last decade, single posterior approaches has been utilized to reduce and stabilize BI and AAD. DCER approach is the most recent and successful procedure.</span></span></span></span></span></span><br> <br> &nbsp; Atlantoaxial dislocation, Basilar invagination, Compression, Distraction, Extension, Reduction 10 17 http://irjns.org/browse.php?a_code=A-10-185-3&slc_lang=en&sid=1 Seyed Reza Mousavi Rezamousavi.ns@gmail.com 100319475328460011212 100319475328460011212 No Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran AND Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Alireza Liaghat alireza.liaghat2@gmail.com 100319475328460011213 100319475328460011213 No Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran Mohammadhadi Amir Shahpari Motlagh mhamirsh@gmail.com 100319475328460011214 100319475328460011214 No Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran Masoud Pishjoo Masoud.pishjoo@gmail.com 100319475328460011215 100319475328460011215 No Department of Neurosurgery, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran Amir Tarokh amirtarokh79@yahoo.com 100319475328460011216 100319475328460011216 No Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran Majidreza farrokhi farokhim@sums.ac.ir 100319475328460011217 100319475328460011217 Yes Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran AND Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran