New Trends in Craniovertebral Junction Surgery

Description:

This issue of Acta Neurochirururgica presents the latest surgical and experimental approaches to the craniovertebral junction (CVJ). It discusses anterior midline (transoral transnasal), posterior (CVJ craniectomy laminectomy, laminotomy, instrumentation and fusion), posterolateral (far lateral) and anterolateral (extreme lateral) approaches using state-of-the-art supporting tools. It especially highlights open surgery, microsurgical techniques, neuronavigation, the O-arm system, intraoperative MR, neuromonitoring and endoscopy. Endoscopy represents a useful complement to the standard microsurgical approach to the anterior CVJ: it can be used transnasally, transorally and transcervically; and it provides information for better decompression without the need for soft palate splitting, hard palate resection, or extended maxillotomy. While neuronavigation allows improved orientation in the surgical field, intraoperative fluoroscopy helps to recognize residual compression. Under normal anatomic conditions, there are virtually no surgical limitations to endoscopically assisted CVJ and this issue provides valuable information for the new generation of surgeons involved in this complex and challenging field of neurosurgery.

Table of Contents:

Part I. Editorial

Why the Craniovertebral Junction?

Part II. Anatomy

The Craniovertebral Junction and Laboratory Experience: The Italian Paradox

Mastering Craniovertebral Junction Surgical Approaches: The Dissection Laboratory Experience at the Catholic University of Rome

Surgical Highways to the Craniovertebral Junction: Is It Time for a Reappraisal?

The Endoscopic Endonasal Approach to Craniovertebral Junction Pathologies: Surgical Skills and Anatomical Study

Endonasal and Transoral Approaches to the Craniovertebral Junction: A Quantitative Anatomical Study

Ventral Brainstem Anatomy: An Endoscopic Transoral Perspective

Transoral Approach to the Craniovertebral Junction: A Neuronavigated Cadaver Study

Part III. Pathophysiology

Atlantoaxial Instability: Evolving Understanding

Ossification of the Posterior Longitudinal Ligament: Analysis of the Role of Craniovertebral and Spinal Instability

Role of Subaxial Spinal and Atlantoaxial Instability in Multisegmental Cervical Spondylotic Myelopathy

The Craniovertebral Junction in Rheumatoid Arthritis: State of the Art

Part IV. Chiari

Chiari Malformations

The Role of Arachnoid Veils in Chiari Malformation Associated with Syringomyelia

Atlantoaxial Fixation for Treatment of Chiari Formation and Syringomyelia with No Craniovertebral Bone Anomaly: Report of an Experience with 57 Cases

The Relationship Between Basilar Invagination and Chiari Malformation Type I: A Narrative Review

Bony Decompression for Chiari Malformation Type I: Long-Term Follow-Up

Surgical Treatment in Symptomatic Chiari Malformation Type I: A Series of 25 Adult Patients Treated with Cerebellar Tonsil Shrinkage

Treatment of Holocord Syringomyelia–Chiari Complex by Posterior Fossa Decompression and a Syringosubarachnoid Shunt in a Single-Stage Single Approach

Surgical Treatment of Chiari Malformation in Adults: Comparison of Surgical Techniques Described in the Literature and Our Experience

Part V. Surgery: Decompression—Lateral Approaches

The High Cervical Anterolateral Retropharyngeal Approach

Compression Syndromes of the Vertebral Artery at the Craniocervical Junction

The Far Lateral Approach to the Craniovertebral Junction: An Update

Endoscope-Assisted Far Lateral Approach to the Craniovertebral Junction with Neuronavigation: A Cadaver Laboratory Experience

Extreme Lateral Approach to the Craniovertebral Junction: An Update

The Extreme Lateral Approach to the Craniovertebral Junction: An Anatomical Study

Part VI. Direct Approaches

Transoral Versus Transnasal Approach for Craniovertebral Junction Pathologies: Which Route Is Better?

The Endonasal Endoscopic Approach to Pathologies of the Anterior Craniocervical Junction: Analytical Review of Cases Treated at Four European Neurosurgical Centres

Endoscopic Endonasal Odontoidectomy and Posterior Fusion in a Single-Stage Surgery: Description of Surgical Technique and Outcome

Endoscopic Endonasal Approaches for Treatment of Craniovertebral Junction Tumours

The Endoscopic Endonasal Approach for Treatment of Craniovertebral Junction Pathologies: A Minimally Invasive but not Minimal-Risk Approach

Stability-Sparing Endoscopic Endonasal Odontoidectomy in a Malformative Craniovertebral Junction: Case Report and Biomechanical Considerations

Refinement of the Transoral Approach to Craniovertebral Junction Malformations

Part VII. CVJ Instrumentation and Fusion

Occipitocervical Fusion

Occipitocervical Fusion: An Updated Review

Wiring or Screwing at the Craniovertebral Junction in Childhood: Past and Present Personal Experience

Retro-odontoid Degenerative Pseudotumour Causing Spinal Cord Compression and Myelopathy: Current Evidence on the Role of Posterior C1–C2 Fixation in Treatment

Insights into the Past and Future of Atlantoaxial Stabilization Techniques

Realignment of Basilar Invagination by C1–C2 Joint Distraction: A Modified Approach to a Paradigm Shift

Grisel’s Syndrome: Non-traumatic Atlantoaxial Rotatory Subluxation—Report of Five Cases and Review of the Literature

Odontoid Fusion

Part VIII. CVJ Trauma

Posttraumatic Anatomical Injuries of the Craniovertebral Junction and Treatment Implications: Part I

Posttraumatic Anatomical Injuries of the Craniovertebral Junction and Treatment Implications: Part II

The Decision-Making Process in Traumatic Lesions of the Craniovertebral Junction: An Evidence-Based Approach? Part I

The Decision-Making Process in Traumatic Lesions of the Craniovertebral Junction: An Evidence-Based Approach? Part II

Type II Odontoid Fracture: a case series highlighting the treatment strategies

Learning Curve in Surgical Treatment of Odontoid Fixation for a Series of Type II C2 Fractures

Functional Outcome After Odontoid Fractures in the Elderly

Part IX. CVJ Infections

Management of Craniovertebral Junction Tuberculosis Presenting with Atlantoaxial Dislocation

Extensive Spinal Epidural Abscesses Resolved with Minimally Invasive Surgery: Two Case Reports and Review of the Recent Literature

Complications of Halo Placement

Part X. CVJ Neurophysiology

Occipital Nerve Stimulation for Refractory Pain after Occipitocervical Fusion

Intraoperative Neurophysiological Monitoring for Craniovertebral Junction Surgery

Management of Anaesthesia

Back Matter