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Extensile exposures to the craniocervical junction and the upper cervical spine in children

Arnold H Menezes1

  • 1Department of Neurosurgery, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USA. arnold-menezes@uiowa.edu

Neurosurgery Clinics of North America
|November 10, 2007
PubMed

Insights

Pediatric craniocervical junction and upper cervical spine abnormalities were historically treated via posterior surgery. Advances in imaging and microsurgery now allow comprehensive surgical access to the entire circumference of this region.

Area of Science:

  • Neurosurgery
  • Pediatric Orthopedics
  • Spinal Surgery

Background:

  • Early surgical interventions for pediatric craniocervical and upper cervical spine abnormalities primarily utilized a posterior approach.
  • Limited access restricted the scope of surgical treatment options.

Purpose of the Study:

  • To highlight the evolution of surgical access to the pediatric craniocervical junction and upper cervical spine.
  • To discuss how technological and anatomical understanding have expanded treatment possibilities.

Main Methods:

  • Review of historical surgical approaches.
  • Integration of advancements in neurodiagnostic imaging.
  • Application of modern microsurgical instrumentation.
  • Enhanced understanding of complex anatomy and pathology.

Main Results:

  • Surgical access has expanded beyond the posterior route.
  • The entire circumference of the upper cervical spine and foramen magnum is now accessible.
  • Minimally invasive techniques are increasingly feasible.

Conclusions:

  • Modern neurosurgical techniques provide comprehensive access to the pediatric craniocervical junction and upper cervical spine.
  • This expanded reach facilitates more effective treatment of complex congenital and acquired abnormalities.

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