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

2019 ◽  
pp. 175-178
Author(s):  
Francesco Signorelli ◽  
Walter Pisciotta ◽  
Vittorio Stumpo ◽  
Pasquale Ciappetta ◽  
Alessandro Olivi ◽  
...  
Keyword(s):  
Anatomical Study ◽  
Craniovertebral Junction ◽  
Lateral Approach

Microsurgical Anatomy of the Hypoglossal Nerve in the Lateral Approaches to the Craniovertebral Junction: A Study on Fresh Non-Formalin-Fixed Human Specimens

2022 ◽  
Author(s):  
Lorenzo Pescatori ◽  
Maria Pia Tropeano ◽  
Manolo Piccirilli ◽  
Pasqualino Ciappetta
Keyword(s):  
Hypoglossal Nerve ◽  
Anatomical Study ◽  
Craniovertebral Junction ◽  
Lateral Approach ◽  
Anterolateral Approach ◽  
Microsurgical Anatomy ◽  
Arteries And Veins ◽  
Formalin Fixed

AbstractThe aim of this anatomical study is to describe the anatomy of the hypoglossal nerve (HN) from its origin to the extracranial portion as it appears by performing a combined posterolateral and anterolateral approach to the craniovertebral junction (CVJ). Twelve fresh, non-formalin-fixed adult cadaveric heads (24 sides) were analyzed for the simulation of the combined lateral approach to the CVJ. The HN is divided into three main parts: cisternal, intracanalicular, and extracranial The anatomical relationships between the HN and other nerves, muscles, arteries and veins were carefully recorded, and some measurements were made between the HN and related structures. Thus, various landmarks were determined for the easy identification of the HN. Understanding the detailed anatomy of the HN and its relationships with the surrounding structures is crucial to prevent some complications during CVJ surgery.

Endoscopic far-lateral approach to the posterolateral craniovertebral junction: an anatomical study

2012 ◽  
Vol 36 (2) ◽  
pp. 239-247 ◽  
Author(s):  
Fuminari Komatsu ◽  
Mika Komatsu ◽  
Antonio Di Ieva ◽  
Manfred Tschabitscher
Keyword(s):  
Anatomical Study ◽  
Craniovertebral Junction ◽  
Lateral Approach ◽  
Far Lateral Approach ◽  
Far Lateral

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

2019 ◽  
pp. 37-44 ◽  
Author(s):  
Francesco Doglietto ◽  
Francesco Belotti ◽  
Jimmy Qiu ◽  
Elena Roca ◽  
Ivan Radovanovic ◽  
...  
Keyword(s):  
Anatomical Study ◽  
Craniovertebral Junction

scholarly journals Lateral Approach to Tumors of the Craniovertebral Junction

1993 ◽  
Vol 103 (3) ◽  
pp. 343???349 ◽  
Author(s):  
Rinaldo F. Canalis ◽  
Neil Martin ◽  
Keith Black ◽  
Mario Ammirati ◽  
Melvin Cheatham ◽  
...  
Keyword(s):  
Craniovertebral Junction ◽  
Lateral Approach

scholarly journals The far-lateral approach: destruction of the condyle does not necessarily result in clinically evident craniovertebral junction instability

2016 ◽  
Vol 125 (1) ◽  
pp. 196-201 ◽  
Author(s):  
Ehab Shiban ◽  
Elisabeth Török ◽  
Maria Wostrack ◽  
Bernhard Meyer ◽  
Jens Lehmberg
Keyword(s):  
Extent Of Resection ◽  
Craniovertebral Junction ◽  
Foramen Magnum ◽  
Lateral Approach ◽  
Occipitocervical Fusion ◽  
Anterior Portion ◽  
Far Lateral Approach ◽  
Clinical Instability ◽  
Craniocervical Instability ◽  
Far Lateral

OBJECT Far-lateral or extreme-lateral approaches to the skull base allow access to the lateral and anterior portion of the lower posterior fossa and foramen magnum. These approaches include a certain extent of resection of the condyle, which potentially results in craniocervical junction instability. However, it is debated what extent of condyle resection is safe and at what extent of condyle resection an occipitocervical fusion should be recommended. The authors reviewed cases of condyle resection/destruction with regard to necessity of occipitocervical fusion. METHODS The authors conducted a retrospective analysis of all patients in whom a far- or extreme-lateral approach including condyle resection of various extents was performed between January 2007 and December 2014. RESULTS Twenty-one consecutive patients who had undergone a unilateral far- or extreme-lateral approach including condyle resection were identified. There were 10 male and 11 female patients with a median age of 61 years (range 22–83 years). The extent of condyle resection was 25% or less in 15 cases, 50% in 1 case, and greater than 75% in 5 cases. None of the patients who underwent condyle resection of 50% or less was placed in a collar postoperatively or developed neck pain. Two of the patients with condyle resection of greater than 75% were placed in a semirigid collar for a period of 3 months postoperatively and remained free of pain after this period. At last follow-up none of the cases showed any clear sign of radiological or clinical instability. CONCLUSIONS The unilateral resection or destruction of the condyle does not necessarily result in craniocervical instability. No evident instability was encountered even in the 5 patients who underwent removal of more than 75% of the condyle. The far- or extreme-lateral approach may be safer than generally accepted with regard to craniocervical instability as generally considered and may not compel fusion in all cases with condylar resection of more than 75%.

Feasible and Accurate Occipitoatlantal Transarticular Fixation: An Anatomic Study

2010 ◽  
Vol 66 (suppl_1) ◽  
pp. ons-173-ons-177 ◽  
Author(s):  
Mehmet Senoglu ◽  
Sam Safavi-Abbasi ◽  
Nicholas Theodore ◽  
Neil R. Crawford ◽  
Volker K.H. Sonntag
Keyword(s):  
Anatomical Study ◽  
Craniovertebral Junction ◽  
Screw Placement ◽  
Occipital Condyle ◽  
X Rays ◽  
Anatomic Study ◽  
Screw Insertion ◽  
Computed Tomographic ◽  
Entry Points ◽  
Transarticular Fixation

Abstract Background: Defining the anatomic zones for the placement of occiput-C1 transarticular screws is essential for patient safety. Objective: The feasibility and accuracy of occiput-C1 transarticular screw placement were evaluated in this anatomical study of normal cadaveric specimens. Material and Methods: Sixteen measurements were determined for screw entry points, trajectories, and lengths for placement of transarticular screws, as applied in the technique described by Grob, on the craniovertebral junction segments (occiput-C2) of 16 fresh human cadaveric cervical spines and 41 computed tomographic reconstructions of the craniovertebral junction. Acceptable angles for screw positioning were measured on digital x-rays. Results: All 32 screws were placed accurately. As determined by dissection of the specimens, none of the screws penetrated the spinal canal. Screw insertion caused no fractures, and the integrity of the hypoglossal canal was maintained in all the disarticulated specimens. Conclusion: Viable transarticular occiput-C1 screw placement is possible, despite variability of the anatomy of the occipital condyle.

Anatomical Study of Sinus Tarsi–Based Lateral Lengthening Calcaneal Osteotomy

2021 ◽  
pp. 107110072110413
Author(s):  
Matthias Aurich ◽  
Mark Lenz ◽  
Gunther O. Hofmann ◽  
Wiebke Schubert ◽  
Matthias Knobe ◽  
...  
Keyword(s):  
Anatomical Study ◽  
Lateral Approach ◽  
Lateral Sinus ◽  
Level Of Evidence ◽  
Sinus Tarsi ◽  
Calcaneal Osteotomy ◽  
Level Ii ◽  
Sinus Tarsi Approach ◽  
Potential Damage ◽  
Extended Lateral Approach

Background: Lateral lengthening calcaneal osteotomy (LL-CO) is commonly performed as a treatment for an abducted midfoot in pes planovalgus deformity. The purpose of this study is to investigate potential damage to medial structures with a sinus tarsi LL-CO. Methods: Sixteen cadaver feet were used. Eight feet had an extended lateral approach, and 8 had a limited lateral (sinus tarsi) approach. All underwent a sinus tarsi LL-CO. Specimens were then dissected to identify inadvertent injury to medial structures. Results: Sinus tarsi LL-CO was associated with damage to the sustentaculum tali and medial articular facets in 56% and 62.5% of specimens, respectively. No anterior or posterior facet injuries were found, although 56% of specimens had a confluent medial and anterior facet. Conclusion: Damage to the medial articular facet and sustentaculum is possible with a flat cut sinus tarsi LL-CO due to the curved nature of the relevant sinus tarsi and canal anatomy. Clinical Relevance: Sinus tarsi LL-CO needs to be performed with caution since damage to the subtalar joint is possible. Level of Evidence: Level II, prospective cohort study.

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