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Measuring Neuromuscular Junction Functionality
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Why the Craniovertebral Junction?

Massimiliano Visocchi1

  • 1Institute of Neurosurgery, Catholic University of Rome, Rome, Italy. mvisocchi@hotmail.com.

Acta Neurochirurgica. Supplement
|January 6, 2019
PubMed
Summary

Understanding the craniovertebral junction (CVJ) anatomy is crucial for safe surgery. This review covers CVJ anatomy, physiology, and surgical approaches to minimize complications.

Keywords:
Craniovertebral junctionEndoscopyExtreme lateral approachFar lateral approachInstrumentation and fusionTransnasal approachTransoral approach

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Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Anatomy

Background:

  • The craniovertebral junction (CVJ) possesses a unique anatomical structure, separating the skull base from the cervical spine.
  • It facilitates cranial flexion, extension, and axial rotation, supported by complex osseous and ligamentous structures.

Purpose of the Study:

  • To review the vascular, ligamentous, and bony anatomy of the CVJ.
  • To discuss surgical approaches and principles of instrumentation for CVJ surgery.
  • To highlight the importance of anatomical knowledge in managing CVJ pathologies and preventing complications.

Main Methods:

  • Review of existing literature on CVJ microsurgical anatomy.
  • Analysis of surgical approaches, including the 360° philosophy.
  • Discussion of personal experience and recent publications.

Main Results:

  • Detailed examination of the anterior and posterior extradural and intradural aspects of the CVJ.
  • Comparison of different surgical exposures.
  • Emphasis on the necessity of anatomical knowledge for preoperative planning and complication avoidance.

Conclusions:

  • Comprehensive understanding of CVJ anatomy, physiology, and surgical approaches is essential for successful CVJ surgery.
  • Managing anterior CVJ lesions remains a significant neurosurgical challenge.
  • Strategic preoperative planning integrating anatomical knowledge and surgical principles is vital.