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      Immersive Surgical Anatomy of the Craniocervical Junction

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          Abstract

          With the advent and increased usage of posterior, lateral, and anterior surgical approaches to the craniocervical junction (CCJ), it is essential to have a sound understanding of the osseous, ligamentous, and neurovascular layers of this region as well as their three-dimensional (3D) orientations and functional kinematics. Advances in 3D technology can be leveraged to develop a more nuanced and comprehensive understanding of the CCJ, classically depicted via dissections and sketches. As such, this study aims to illustrate - with the use of 3D technologies - the major anatomical landmarks of the CCJ in an innovative and informative way. Photogrammetry, structured light scanning, and 3D reconstruction of medical images were used to generate these high-resolution volumetric models. A clear knowledge of the critical anatomical structures and morphometrics of the CCJ is crucial for the diagnosis, classification, and treatment of pathologies in this transitional region.

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          Vertebral artery injuries in cervical spine surgery

          Gregory D. Schroeder, Wellington K. Hsu (2013)
          Background: Vertebral artery injuries during cervical spine surgery are rare, but potentially fatal. When performing cervical spine surgery, it is imperative that the surgeon has a systematic approach for avoiding, and if necessary, dealing with a vertebral artery injury. Methods: This is a review paper. Results: Upper posterior cervical spine surgeries put the vertebral artery at the highest risk, as opposed to anterior subaxial cervical spine procedures, which put the artery at the least risk. A thorough understanding of the complex anatomy of the vertebral artery is mandatory prior to performing cervical spine surgery, and since the vertebral artery can have a variable course, especially in the upper cervical spine, the surgeon must minimize the possibility of an arterial injury by preoperatively assessing the artery with a computed tomography (CT) scan or magnetic resonance imaging (MRI). Intraoperatively, the surgeon must be aware of when the vertebral artery is most at risk, and take precautions to avoid an injury. In the event of an arterial injury, the surgeon must have a plan of action to (1) Achieve control of the hemorrhage. (2) Prevent acute central nervous system ischemia. (3) Prevent postoperative complications such as embolism and pseudoaneurysm Conclusion: Prior to performing cervical spine surgery, one must understand the four A's of vertebral artery injuries: Anatomy, Assessment, Avoidance, and Action.
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            Construction of Neuroanatomical Volumetric Models Using 3-Dimensional Scanning Techniques: Technical Note and Applications

            Roberto Rodriguez Rubio, Joseph Shehata, Ioannis Kournoutas … (2019)
            Visuospatial features of neuroanatomy are likely the most difficult concepts to learn in anatomy. Three-dimensional (3D) modalities have gradually begun to supplement traditional 2-dimensionanl representations of dissections and illustrations. We have introduced and described the workflow of 2 innovative methods-photogrammetry (PGM) and structured light scanning (SLS)-which have typically been used for reverse-engineering applications. In the present study, we have described a novel application of SLS and PGM that could enhance medical education and operative planning in neurosurgery.
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              Occipital neuralgia: anatomic considerations.

              Alper Cesmebasi, Mitchel A Muhleman, Paul Hulsberg … (2015)
              Occipital neuralgia is a debilitating disorder first described in 1821 as recurrent headaches localized in the occipital region. Other symptoms that have been associated with this condition include paroxysmal burning and aching pain in the distribution of the greater, lesser, or third occipital nerves. Several etiologies have been identified in the cause of occipital neuralgia and include, but are not limited to, trauma, fibrositis, myositis, fracture of the atlas, and compression of the C-2 nerve root, C1-2 arthrosis syndrome, atlantoaxial lateral mass osteoarthritis, hypertrophic cervical pachymeningitis, cervical cord tumor, Chiari malformation, and neurosyphilis. The management of occipital neuralgia can include conservative approaches and/or surgical interventions. Occipital neuralgia is a multifactorial problem where multiple anatomic areas/structures may be involved with this pathology. A review of these etiologies may provide guidance in better understanding occipital neuralgia.
              Article 0 comments Cited 12 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Cureus
                Journal ID (iso-abbrev): Cureus
                Journal ID (issn): 2168-8184
                Title: Cureus
                Publisher: Cureus (Palo Alto (CA) )
                ISSN (Electronic): 2168-8184
                Publication date (Electronic, pub): 10 September 2020
                Publication date (Electronic, collection): September 2020
                Volume: 12
                Issue: 9
                Electronic Location Identifier: e10364
                Affiliations
                [1 ] Neurological Surgery, University of California San Francisco, San Francisco, USA
                [2 ] Neurological Surgery, First Affiliated Hospital of China Medical University, Shenyang, CHN
                [3 ] Neurological Surgery, University of Caifornia San Francisco, San Francisco, USA
                [4 ] Neurological Surgery, Ferrara University Hospital, Ferrara, ITA
                Author notes
                Article
                DOI: 10.7759/cureus.10364
                PMC ID: 7549867
                PubMed ID: 33062487
                SO-VID: 5413e3ed-d854-4867-83ed-2926576f3a75
                Copyright © Copyright © 2020, Vigo et al.
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 27 August 2020
                Date accepted : 10 September 2020
                Categories
                Subject: Neurosurgery
                Subject: Orthopedics
                Subject: Anatomy

                Keywords: craniocervical junction,atlas,axis,occipital bone,biomechanics,cruciform ligament,volumetric model,neuroanatomy,surgical lines
                Data availability:
                Keywords: craniocervical junction, atlas, axis, occipital bone, biomechanics, cruciform ligament, volumetric model, neuroanatomy, surgical lines

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