Search results for "Craniovertebral junction"
showing 5 items of 5 documents
Craniovertebral Junction Transanasal and Transoral Approaches: Reconstruct the Surgical Pathways with Soft or Hard Tissue Endocopic Lines? This Is th…
2017
A variety of pathological conditions may affect the clivus and the craniovertebral junction (CVJ). These include congenital disorders, chronic inflammation, neoplasms, infections, and posttraumatic conditions that could all result in CVJ compression and myelopathy Endoscopic-assisted procedures have been further developed for CVJ decompression and they have now become conventional approaches. The aims of the present study were: (1) to compare “radiological” and “surgical” nasoaxial lines (NAxLs); (2) to introduce an analogous radiological line as a predictor of the superior extension of the transoral approach (palatine inferior dental arch line (PIA); (3) to compare the “radiological” nasop…
Complications in Craniovertebral Junction Instrumentation: Hardware Removal Can Be Associated with Long-Lasting Stability. Personal Experience
2017
Background The causes of craniovertebral junction (CVJ) instabilities include trauma, rheumatological diseases, tumors, infections, congenital malformations, and degenerative disease processes; these complex pathologies often require CVJ instrumentation. Hardware complications were analyzed in a personal series of 48 treated patients. In light of the analysis of very unusual radiological and clinical findings, the authors tried to better investigate the related mechanisms and to reach possible useful conclusions. Methods In a series of 48 patients who underwent CVJ instrumentation and fusion procedures in our Institution, we describe three cases of hardware failure, due to: (1) infection; (…
Walk the Line. The Surgical Highways to the Craniovertebral Junction in Endoscopic Approaches: A Historical Perspective
2018
Background We compiled a comprehensive literature review on the anatomic and clinical results of endoscopic approaches to the craniocervical junction (CVJ) to better contribute to identify the best strategy. Methods An updated literature review was performed in the PubMed, OVID, and Google Scholar medical databases, using the terms “Craniovertebral junction,” “Transoral approach,” “Transnasal approach,” “Transcervical approach,” “Endoscopic endonasal approach,” “Endoscopic transoral approach,” “Endoscopic transcervical approach.” Clinical series, anatomic studies, and comparative studies were reviewed. Results Pure endonasal and cervical endoscopic approaches still have some disadvantages, …
Direct and oblique approaches to the craniovertebral junction: Nuances of microsurgical and endoscope-assisted techniques along with a review of the …
2017
Purpose: The aim of this review is to provide an update of the technical nuances of microsurgical and endoscopic-assisted approaches to the craniovertebral junction (transnasal, transoral, and transcervical), and to report on the available clinical results in order to identify the best strategy. Methods: A nonsystematic update of the reviews and reporting on the anatomical and clinical results of endoscopic-assisted and microsurgical approaches to the craniovertebral junction (CVJ) was performed. Results: Pure endonasal and cervical endoscopic approaches still have some disadvantages, including their steep learning curves and their deeper surgical fields. Endoscopically assisted transoral s…
The craniovertebral junction in rheumatoid arthritis: State of the art
2019
Rheumatoid arthritis (RA) is a chronic inflammatory disorder, characterized by polyarticular inflammation causing progressive joint damage and disability. The mechanisms underlying its pathogenesis involve activation of innate and adaptive immunity, microvascular endothelial cell activation, and inflammatory infiltration of lymphocytes and monocytes into the synovium. Spinal involvement in RA is not typical; when it occurs, the main radiological features are (1) atlantoaxial subluxation (AAS), which is the most typical form of cervical spine involvement; (2) cranial settling—also known as basilar impression, atlantoaxial impaction or superior migration of the odontoid—which is the most seve…