Relevant anatomy of the craniovertebral junction request pdf. Massimiliano visocchi institute of neurosurgery, catholic university, largo gemelli, 8 00168 rome, italy introduction in the modern surgical approach to the craniovertebral junction cvj, past and. Tumors of the craniovertebral junction clinical gate. Diagnosis, pathology, surgical techniques provides indepth coverage of uptodate management principles for this delicate anatomic region. Surgical anatomy and techniques to the spine 2nd edition pdf. Craniovertebral junction the craniovertebral or craniocervical junctioncvj is a collective term that refers to the occiput posterior skull base, atlas, axis, and supporting ligaments. Neurosurgery surgery of the craniovertebral junction. Craniovertebral junction reducible and irreducible compressive pathologies. Anatomy and biomechanics of normal craniovertebral junction a and biomechanics of stabilization b.
Lesions of the craniovertebral junction do affect the pediatric population, although to a lesser extent than they affect adults. Figure 231 the craniocervical junction anatomy with ligaments and bursae present. The gap between the axis and the free ossicle usually extends above. Normal anatomy with mr correlation article pdf available in american journal of roentgenology 1585. Cvj anomalies that decrease the volume of the posterior cranial fossa e. Normal anatomy, craniometry, and congenital anali1 wendy r. Craniovertebral junction surgery involves an appropriate philosophical, biomechanical and anatomical understanding apart from high degree of technical skill and ability of controlling venous and arterial bleeding. Radiological assessment of the craniovertebral junction. Chapter 23 the craniovertebral region chapter objectives at the completion of this chapter, the reader will be able to. Anomalies of the cvj may be congenital or acquired. Craniovertebral junction reducible and irreducible. These anomalies can lead to cranial nerve compression, vertebral artery compression and obstructive hydrocephalus.
All these joints function as 1 unit to generate the movement of rotation of atlas with head around the vertical axis. Craniovertebral joints definition of craniovertebral. Richard mendel md, spinal neurosurgeon, speaks of the craniovertebral junction, its anatomy, pathology, and treatments. Anatomy and biomechanics of the craniovertebral junction. Ventromedial part of the somatomes migrate and cluster around notochord sclerotomes. Surgical anatomy and techniques to the spine 2nd edition pdf for free. T he craniovertebral junction cvjdefined as the occiput, atlas, and axisis a complex area that houses vital neural and vascular structures while achieving the most mobility of any segment within the spine. Craniovertebral junction cvj anomalies can be congenital, developmental or due to malformation secondary to any acquired disease process. Surgery of the craniovertebral junction 2nd edition pdf. This region has unique nomenclature, embryology, anatomy, vasculature, biomechanics and pathology. The journal allows free access open access to its contents and permits authors to selfarchive final accepted version of the articles on any oaicompliant. Following a brief introduction to the relevant anatomy and biomechanics of cvj, it explores the field of craniovertebral junction lesions and their management. Spinal cord compression if the anteroposterior diameter of the foramen magnum behind the odontoid process is craniometry, anamolies and radiology slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising.
Ct anatomy of the craniovertebral junction in infants and. The craniovertebral junction cvj is composed of the occiput, the foramen magnum, and the first two cervical vertebrae, encompassing the medulla oblongata and the upper cervical spinal cord. After a brief introduction to anatomy, biomedical considerations, and embryology, the multidisciplinary team of authors, led by professor goel, discusses in detail the most innovative. Craniovertebral junction anomalies knowledge for medical students and physicians a fissure in each sclerotome separate a denser caudal half from loosely arranged cranial half. This website provides free ebooks to read or download in. Cvj comprises the occiput, atlas, and axis and is visible. Each row of three thumbnails correspond to a given level and the green cross indicates the reference planes for each image of this level. The original and definitive reference on surgery of the craniovertebral junction, now in an updated second edition. Craniocervical junction abnormalities can cause or contribute to cervical spinal cord or brain stem compression. Atlas of craniocervical junction and cervical spine surgery.
The craniovertebral junction is the most complex of the axial skeleton, residing between the skull and the upper cervical spine. Anatomy of the craniovertebral junction cvj includes the foramen magnum located in the occipital bone, atlas c1, and axis c2 united by ligaments and muscles, the lower cranial. Pdf the anatomy of the craniovertebral junction, although complex, may be well. Craniovertebral junction anomalies knowledge for medical students and physicians. The craniovertebral junction is an intricate structure with unique anatomy and complex biomechanical characteristics. After a brief introduction to anatomy, biomedical considerations, and embryology, the multidisciplinary team of authors, led by professor goel, discusses in detail the most innovative fixation.
It represents a fibrocartilagenous surface ventrally, allowing a free gliding. Craniovertebral junction is a unique reference tool for a unique topic. Craniovertebral junction anomalies radiology reference. The craniovertebral junction cvj area refers to the osseous structures consisting of the occipital bone that surrounds the foramen magnum, the atlas, and the axis vertebrae. Anatomy, pathology, surgery richard mendel md, spinal neurosurgeon, speaks of the craniovertebral junction, its anatomy, pathology, and treatments. Furthermore, individual chapters cover endovascular surgery, endoscopic skull base techniques, navigation and. Atlas of craniocervical junction and cervical spine surgery springer. Craniovertebral junction anomalies knowledge for medical.
The craniovertebral junction cvj is composed of the occiput, the foramen magnumand the first two cervical vertebrae, encompassing the medulla oblongata and the upper cervical spinal cord. Written by masters in the field, the craniovertebral junction. The journal is registered with the following abstracting partners. These characteristics allow for significant flexion, extension, and axial rotation with remarkable stability under normal circumstances. Ksmoker, md the craniovertebral junction cvj comprises the occiput, atlas, and axisand isvisible inmost magnetic resonance mr imaging studies of the brain. The craniovertebral junction cvj has unique anatomical structures that separate it from the subaxial cervical spine. Chapter 7 craniocervical developmental anatomy and its implications. The craniocervical junction is a distinct osseo ligamentous entity with specific. The craniovertebral junction cvj comprises the occiput, atlas, and axis and is visible in most magnetic resonance mr imaging studies of the brain.
Craniovertebral junction abnormalities thieme connect. Craniometric measurements used in radiologic assessment of cvj anomalies include the chamberlain line, wackenheim clivus baseline, welcher basal angle, and atlantooccipital joint axis angle. The majority of the spines rotation, flexion, and extension occur between the occiput, the atlas, and axis. The imaging characteristics and differential diagnoses of these lesions are provided. Evolution of transoral approaches, endoscopic endonasal approaches, and reduction strategies for treatment of craniovertebral junction pathology. In blunt trauma, the anatomical biomechanical demands of the ligaments warrant consideration. It discusses anterior midline transoral transnasal, posterior cvj craniectomy laminectomy, laminotomy, instrumentation and fusion, posterolateral far lateral and anterolateral extreme lateral approaches using stateoftheart supporting tools.
Describe the biomechanics of the craniovertebral joints, including coupled movements, normal and abnormal joint barriers, and kinesiology. Anatomy and biomechanics of normal craniovertebral. Surgical anatomy of the vertebral artery at craniovertebral junction level. The author presents his 30year experience with treating complex craniovertebral junction instability related surgical issues. Craniovertebral junction anomalies linkedin slideshare. It includes some ligaments and membranes such as the alar ligament, cruciform ligament, apical ligament, atlantoaxial accessory, capsular joints, tectorial membrane tm. Congenital and developmental osseous anomalies and abnormalities that affect the craniovertebral. The craniovertebral junction, with a significant range of pathologies and anatomical complexities, continues to be a challenging area for surgeons. The craniovertebral junction is imaged on every brain, neck and cervical spine mr and ct study performed. Anatomy and biomechanics of the craniovertebral junction in. Describe the anatomy of the vertebrae, ligaments, muscles, and blood and nerve supply that comprise the craniovertebral segments. Biomechanics of the craniovertebral junction intechopen.
This issue of acta neurochirururgica presents the latest surgical and experimental approaches to the craniovertebral junction cvj. Surgery of the craniovertebral junction enrico tessitore springer. Vertebral artery in relationship to c1c2 vertebrae. Craniovertebral junction the craniovertebral or craniocervical junction cvj is a collective term that refers to the occiput posterior skull base, atlas, axis, and supporting ligaments. Craniometric measurements used inradiologic assessment.