Level Of Craniovertebral Junction Research Articles

Minimally invasive surgical treatment of extramedullary tumors at the level of craniovertebral junction: experience of the Burdenko Neurosurgical Center

To describe own experience of treating patients with extramedullary tumors at the level of craniovertebral junction using minimally invasive surgical approaches. The study included 29 patients who underwent minimally invasive microsurgical resection of extramedullary tumors at the level of craniovertebral junction. We analyzed the main clinical and surgical parameters. Gross total resection was achieved in most patients with high degree of safety. Two patients required redo surgery due to CSF leakage and soft tissue cyst. Mean length of hospital-stay was 7 days. VAS score of pain syndrome at discharge was 2 points and 0 points after 3 months. No significant differences in neurophysiological monitoring indicators were observed (p=0.76). Minimally invasive posterior approaches to extramedullary tumors at the level of craniovertebral junction can significantly reduce surgical trauma with equal extent of resection.

Benign extramedullary spinal cord tumors at the level of craniovertebral junction: a systematic review

Extramedullary spinal cord tumors at the level of craniovertebral junction are a rare group of neoplasms with their own characteristics. Taking into account the peculiarities of clinical course and complex anatomy of craniovertebral complex, these tumors present a complex diagnostic and surgical problem. A systematic review of literature data on epidemiology, clinical picture, diagnostic methods and dorsal minimally invasive methods of surgical treatment of patients with extramedullary spinal cord tumors of craniovertebral junction was performed.

TREATMENT OF A PATIENT WITH MUCOPOLYSACCHARIDOSES TYPE II (HUNTER SYNDROME) COMPLICATED BY CRANIOVERTEBRAL SPINAL CANAL STENOSIS

Formation of spinal canal stenosis at T12-L1 level, rarely at the level of craniovertebral junction, is a typical spinal disorder in different types of mucopolysaccharidoses that is a serious complication due to tetraparesis and tetraplegia development. Clinical, roentgenologic and therapeutic aspects of the mucopolysaccharidoses type II course in a 23 months old boy as well as the results of two-step surgical treatment for the cervical spine stabilization and elimination of spinal canal stenosis at the level of craniovertebral junction are presented.

Treatment of a patient with mucopolysaccharidoses type II (Hunter syndrome) complicated by craniovertebral spinal canal stenosis

Formation of spinal canal stenosis at T12-L1 level, rarely at the level of craniovertebral junction, is a typical spinal disorder in different types of mucopolysaccharidoses that is a serious complication due to tetraparesis and tetraplegia development. Clinical, roentgenologic and therapeutic aspects of the mucopolysaccharidoses type II course in a 23 months old boy as well as the results of two-step surgical treatment for the cervical spine stabilization and elimination of spinal canal stenosis at the level of craniovertebral junction are presented.

Importance of C1 laminectomy in foramen magnum decompression surgery: A technical note

Arnold-Chiari malformations (ACM) of the brain result from aberrations in the development of the posterior fossa resulting in its smaller volume leading to tonsillar herniation. The most common type includes Type I ACM where tonsillar descent reaches up to either C1 or C2 along with cervico-dorsal syringomyelia. The surgery (foramen magnum decompression, [FMD]) is usually straight forward and includes sub-occipital craniectomy and cervical laminectomy based on the level of descent. Rarely inadequate cervical laminectomy of C1 arch may result in residual compression at the level of obex even after “lax” duraplasty. A cervico-dural angle (angle between the neo-dura and cervical dura) at level foramen magnum can be observed in these patients. This angle is usually obtuse in imaging of cranio-vertebral junction (CVJ) of normal people and in postoperative patients of Chiari malformations where normal anatomy is restored. Inadequate C1 laminectomy may result in an acute cervico-dural angle with residual compression at the level of CVJ. Therefore, C1 laminectomy becomes a key step in FMD surgery that is often underemphasized, and neurosurgeons should be careful in doing it adequately.