The osseous, ligamentous, muscular, and vascular anatomy are each presented in the craniovertebral section. The latest management strategies for complex lesions of the craniovertebral junction. Surgery of the craniovertebral junction enrico tessitore. Diagnosis, pathology, surgical techniques provides indepth coverage of uptodate management principles for this delicate anatomic region. Craniovertebral junction the craniovertebral or craniocervical junction cvj is a collective term that refers to the occiput posterior skull base, atlas, axis, and supporting ligaments. This atlas documents current surgical approaches to the craniocervical junction and the cervical spine, providing stepbystep guidance on procedures and cervical spine stabilization techniques.
Neuroimaging in craniovertebral anomalies as seen in the tropics. Written by masters in the field, the craniovertebral junction. Craniovertebral junction cvj anomalies can be congenital, developmental or due to malformation secondary to any acquired disease process. Imageswereobtamedwithai0cmfieldofview,a256x192matrix,andtwosignal acquisitions. Describe the anatomy of the vertebrae, ligaments, muscles, and blood and nerve supply that comprise the craniovertebral segments. The craniovertebral junction is an intricate structure with unique anatomy and complex biomechanical characteristics. Surgery of the craniovertebral junction 2nd edition pdf. These characteristics allow for significant flexion, extension, and axial rotation with remarkable stability under normal circumstances. Spinecho sequences, 300035 trite, withaslice thickness of4mmandimminterslicegapwereused. Craniometric measurements used in radiologic assessment of cvj anomalies include the chamberlain line, wackenheim clivus baseline, welcher basal angle, and atlantooccipital joint axis angle.
Imaging of the craniovertebral junction sciencedirect. Craniovertebral junction anatomy and biomechanics ventral to the spinal cord, the tectorial membrane extends superiorly as a continuation of the posterior longitudinal ligament. Among the 32 normal subjects, 17 were male, and among the 65 malformation patients, 30 were male chisquare, p 0. Craniovertebral junction the craniovertebral or craniocervical junction cvj is a collective term that refers to the occiputp. Computed tomography and mri have complementary roles.
Book the latest updates of specialized neurosurgical and spine, pdf, kindle, epub. Advances in multidetector computed tomography and magnetic resonance imaging mri have provided better insight into the normal anatomy and pathology of this complex area. Page 2 of 64 learning objectives to outline normal anatomy of the craniovertebral junction cvj. Surgical anatomy and techniques to the spine 2nd edition pdf. Anatomy and development of the craniovertebral junction. Opening chapters present essential information on anatomy, depict pathologies with the aid of. It discusses anterior midline transoral transnasal, posterior cvj craniectomy laminectomy, laminotomy, instrumentation and fusion, posterolateral far lateral and anterolateral extreme lateral approaches using stateoftheart supporting tools. The assi monographs are a series of books commissioned by the association of spine surgeons of india with the goal of providing updated information, decisionmaking algorithms, and surgical techniques on selected spinal problems. To resume the most common developmental and acquired cvj abnormalities that are often encountered during cranial or spine plain film, ct or mr evaluation. Reconstruction of upper cervical spine and craniovertebral. Spinal tb, first described by sir percival pott in the 18 th century, accounts for 50% of these cases and results in immense morbidity and mortality. In vitro biomechanics of the craniocervical junction a sequential sectioning of its stabilizing structures. After a brief introduction to anatomy, biomedical considerations, and embryology, the multidisciplinary. Microsurgical anatomy of the region of the foramen magnum.
In blunt trauma, the anatomical biomechanical demands of the ligaments warrant consideration. The craniovertebral junction is a complex region that incorporates the occiputc1c2 portions of the spine. Craniovertebral junction anomalies radiology reference. Magnetic resonance imaging of the craniovertebral junction. The craniovertebral junction pdf written by masters in the field, the craniovertebral junction. Ct scan was done which showed cord compression by the odontoid fig. These anomalies can lead to cranial nerve compression, vertebral artery compression, and obstructive hydrocephalus. Schweitzer,1 jurghodler,2 vinicio cervilla,2 anddonald resnick2 theanatomyofthecraniovertebral junction,althoughcomplex, maybewellvisualized byroutinemrimaging. Following a brief introduction to the relevant anatomy and biomechanics of cvj, it explores the field of craniovertebral junction lesions and their management. This book provides a unique tool for approaching craniovertebral junction cvj surgery. The craniovertebral junction cvj has unique anatomical structures that separate it from the subaxial cervical spine. Anatomy and biomechanics of normal craniovertebral junction a and biomechanics of stabilization b. Congenital malformations of the craniovertebral junction. In this chapter, we are provide such a guide through the surgical anatomy the craniovertebral junction.
Pdf the craniovertebral junction and laboratory experience. Featuring an expanded focus on indemand endoscopic and minimally invasive spine procedures, surgical anatomy and techniques to the spine, 2nd edition pairs new anatomic photographs and radiographic images with expertly rendered color illustrations and clear, stepbystep descriptions to help you effectively perform. This new edition of surgery of the craniovertebral junction focuses on surgical decision making and technological advances in the treatment modalities for this region. It encloses the soft tissue structures of the cervicomedullary junction.
Atlas of craniocervical junction and cervical spine surgery. The craniovertebral junction in rheumatoid arthritis. The craniovertebral junction, with a significant range of pathologies and anatomical complexities, continues to be a challenging area for surgeons. After a brief introduction to anatomy, biomedical considerations, and embryology, the multidisciplinary team of authors, led by professor goel, discusses in detail the most innovative fixation and stabilization techniques for atlantoaxial dislocation, as well as congenital, infective, and acquired anomalies in the craniovertebral junction region. A 17yearold boy had previously undergone posterior fossa and upper cervical decompression for hindbrain herniation and a ventral craniovertebral abnormality. Dehdashti editor, claudio this book provides a unique tool for approaching craniovertebral junction cvj surgery. Tb of the craniocervical junction is rare and accounts for. This new edition of surgery of the craniovertebral junction focuses on surgical decision making and technological. Jul 22, 2017 anatomy of the craniovertebral junction dr sumit kumar radiology pg slims 2.
Craniovertebral junction anomalies knowledge for medical students and physicians mesodermal somites numbering 42 appear at the 4th week ventromedial part of the somatomes migrate and cluster around notochord sclerotomes a fissure in each sclerotome separate a denser caudal half from loosely arranged cranial half. Beginning at the posterior vertebral body of c2, the tectorial membrane fans out laterally over the dens and associated ligaments, attaching to the superior. The neural network algorithm evaluated in this study automatically and autonomously analyzes dicom spine scan data and then segments and identifies the various components. Surgical anatomy of the craniocervical junction springerlink. Pdf the anatomy of the craniovertebral junction, although complex, may be well visualized by routine mr imaging. Surgery of the craniovertebral junction, 2e original. Tuberculosis tb is a worldwide health problem, according to the world health organization it is the leading infectious cause of mortality worldwide killing 1. Journal of craniovertebral junction and spine volume 11 issue 2 apriljune 2020 83 descriptions presented in the literature. Atlas of craniocervical junction and cervical spine. Sep 01, 2005 craniovertebral junction cvj abnormalities involve the osseous structures and the contained nervous system. The craniovertebral junction cvj is a collective term that refers to the occiput posterior skull base, atlas, axis, and supporting ligaments.
It is a transition between the cranium and the mobile cervical spine that permits. Cv junction the craniovertebral junction cvj refers anatomically to the occiput, the first atlas and second cervical axis vertebral segments articulations and connecting ligaments. It encloses the soft tissue structures of the cervicomedullary junction medulla, spinal cord, and lower cranial nerves. Neurosurgery surgery of the craniovertebral junction. Craniometric measurements used in radiologic assessment of cvj anomalies include the chamberlain line, wackenheim clivus baseline, welcher basal angl. Describe the biomechanics of the craniovertebral joints, including coupled movements, normal and abnormal joint barriers, and kinesiology. Anatomic and radiologic appearance of several variants of. In addition to housing vital neural and vascular structures, the majority of cranial flexion, extension, and axial rotation is accomplished at the cvj. Furthermore, individual chapters cover endovascular surgery, endoscopic skull base techniques, navigation and. Anatomy and biomechanics of the craniovertebral junction in. Sep 01, 2005 note the gross ventral indentation of the cervicomedullary junction by the odontoid invagination. T he craniovertebral junction cvjdefined as the occiput, atlas, and axisis a complex area that houses vital neural and vascular structures while achieving the most mobility of any segment within the spine.
Lateral film of xray of the craniovertebral junction with the head in flexion. Biomechanics of the craniovertebral junction intechopen. Surgery of the craniovertebral junction springerlink. Craniovertebral junction will be immensely beneficial to. The imaging characteristics and differential diagnoses of these lesions are provided. Organized into four main parts, the book begins by examining the embryology, anatomy, imaging, and biomechanics of the craniovertebral junction, then proceeds to the diagnosis, pathology, and clinical management of disorders affecting this region.
Jan, 2011 after a brief introduction to anatomy, biomedical considerations, and embryology, the multidisciplinary team of authors, led by professor goel, discusses in detail the most innovative fixation and stabilization techniques for atlantoaxial dislocation, as well as congenital, infective, and acquired anomalies in the craniovertebral junction region. The craniovertebral junction cvj comprises the occiput, atlas, and axis and is visible in most magnetic resonance mr imaging studies of the brain. Embryology of the craniocervical junction and posterior cranial. Surgical anatomy and techniques to the spine 2nd edition pdf free download. This issue of acta neurochirururgica presents the latest surgical and experimental approaches to the craniovertebral junction cvj. Anatomic and radiologic appearance of several variants of the. This essay discusses the anatomy of the complex articulations of the craniovertebral junction.
Techniques in the treatment of craniovertebral instability. New trends in craniovertebral junction surgery springerlink. These anomalies can lead to cranial nerve compression, vertebral artery compression and obstructive hydrocephalus. Anatomy and biomechanics of the craniovertebral junction. The craniovertebral region duttons orthopaedic examination. Representative mr images and gross anatomic photographs are presented to illustrate the intricate ligamentous and articular anatomy. Following a brief introduction to the relevant anatomy and biomechanics of cvj, it explores the field of craniovertebral junction.
The majority of the spines rotation, flexion, and extension occur between the occiput, the atlas, and axis. Surgery of the craniovertebral junction surgery books. Feb 22, 2017 the craniovertebral junction pdf written by masters in the field, the craniovertebral junction. The anatomy of the craniovertebral junction, although complex, may be well visualized by routine mr imaging. Onespecimen wasprecisely marked atthelevelsatwhichthe sagittalimageswereobtained.
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