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Sutures of the Skull

Sutures of the Skull

The human skull is composed of several bones that come together to protect the brain and support the structures of the face. The junctions where these bones meet are called sutures.
Sutures are immobile joints between adjacent bones of the skull. The narrow gap between the bones is filled with dense, fibrous connective tissue that unites the bones. The long sutures located between the skull bones are not straight but instead follow irregular, tightly twisting paths. These twisting lines tightly...

Cranial and Spinal Meninges

Cranial and Spinal Meninges

The cranial and spinal meninges are complex protective structures surrounding the central nervous system (CNS), consisting of the brain and spinal cord. These meninges consist of the dura mater, the arachnoid mater, and the pia mater. They protect the CNS, provide structural support, and aid in circulating cerebrospinal fluid (CSF).
Cranial Meninges
These meningeal layers cover the cranium. The dura mater is the outermost layer of cranial meninges. It is a thick and durable membrane of dense...

Cranial Bones: Superior and Posterior View

Cranial Bones: Superior and Posterior View

The superior view of the cranium shows the frontal and paired parietal bones.
The frontal bone is the single bone that forms the forehead. At its anterior midline, between the eyebrows, there is a slight depression called the glabella. The frontal bone also forms the supraorbital margin of the orbit. Near the middle of this margin is the supraorbital foramen, the opening that provides passage for a sensory nerve to the forehead. The frontal bone is thickened just above each supraorbital margin,...

Articulations of the Vertebral Column

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Vertebral Column: Regions and Curvature

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Related Experiment Videos

Craniocervical fusions in children.

Arnold H Menezes¹

¹Department of Neurosurgery, University of Iowa Hospitals and Clinics, University of Iowa Carver College of Medicine, Iowa City, IA, USA.

Journal of Neurosurgery. Pediatrics

|June 5, 2012

Summary

This summary is machine-generated.

Pediatric craniovertebral junction (CVJ) instability requires specialized surgical techniques. This review of over 850 pediatric CVJ fusions shows high success rates with modern instrumentation, ensuring safe craniocervical stabilization.

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Area of Science:

Neurosurgery
Pediatric Orthopedics
Spine Surgery

Background:

Pediatric craniovertebral junction (CVJ) instability presents unique surgical challenges due to anatomical variations and smaller structures compared to adults.
Syndromic abnormalities and diminutive osseous/ligamentous components further complicate management.
Advances in imaging and instrumentation have enhanced treatment options for pediatric craniocervical stabilization.

Purpose of the Study:

To review the author's extensive experience with over 850 pediatric craniovertebral junction (CVJ) fusions.
To detail the indications and surgical techniques for atlantoaxial arthrodesis and occipitocervical fusion in children.
To assess the outcomes, complications, and long-term effects of pediatric CVJ stabilization.

Main Methods:

Review of surgical techniques for pediatric atlantoaxial and occipitocervical fusions, including historical (interlaminar rib graft) and modern (screw and rod fixation) approaches.
Description of specific fixation methods: transarticular screws, lateral mass screws, C-2 pars/pedicle screws, C-2 translaminar screws, and contoured loop fixation.
Analysis of outcomes based on fusion success rates and observed effects on spinal growth and patient well-being.

Main Results:

Bone fusion success rates reached 98% with fusion alone and nearly 100% with rigid instrumentation.
No abnormal spine growth was observed in children stabilized below age 5.
No deleterious effects were noted in children treated with rigid instrumentation, indicating safety and efficacy.

Conclusions:

Modern surgical techniques and instrumentation provide highly successful and safe management for pediatric craniovertebral junction instability.
Craniocervical stabilization in pediatric patients can be achieved with excellent fusion rates and without compromising spinal growth.
Detailed understanding of indications, techniques, and complication management is crucial for optimal outcomes in pediatric CVJ surgery.