Evaluation and Surgical Planning for Craniovertebral Junction Deformity

Neurospine

Jong Beom Lee¹  Sang Hyo Lee²  Jae Taek Hong²  Jeong Woo Hur²  Jeong Jae Lee³  Jong Hyuk Park⁴  Ho Jin Lee⁵  Il Sup Kim⁵ 

[1] Department of Neurosurgery, Chungbuk National University, Cheongju, Korea;Department of Neurosurgery, Eunpyeong St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea;Department of Neurosurgery, GangNeung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea;Department of Neurosurgery, Incheon St. Mary’s Hospital, The Catholic University of Korea, Incheon, Korea;Department of Neurosurgery, St. Vincent’s Hospital, The Catholic University of Korea, Suwon, Korea;

关键词: craniovertebral junction;    alignment;    kyphosis;    basilar invagination;    deformity;    treatment;   

DOI  :  10.14245/ns.2040510.255

来源: DOAJ

【 摘 要 】

Craniovertebral junction (CVJ) deformity is a challenging pathology that can result in progressive deformity, myelopathy, severe neck pain, and functional disability, such as difficulty swallowing. Surgical management of CVJ deformity is complex for anatomical reasons; given the discreet relationships involved in the surrounding neurovascular structures and intricate biochemical issues, access to this region is relatively difficult. Evaluation of the reducibility, CVJ alignment, and direction of the mechanical compression may determine surgical strategy. If CVJ deformity is reducible, posterior in situ fixation may be a viable solution. If the deformity is rigid and the C1–2 facet is fixed, osteotomy may be necessary to make the C1–2 facet joint reducible. C1–2 facet release with vertical reduction technique could be useful, especially when the C1–2 facet joint is the primary pathology of CVJ kyphotic deformity or basilar invagination. The indications for transoral surgery are becoming as narrow as a treatment for CVJ deformity. In this article, we will discuss CVJ alignment and various strategies for the management of CVJ deformity and possible ways to prevent complications and improve surgical outcomes.

【 授权许可】

Unknown