Computer tomography navigation for the transoral anterior release of a complex craniovertebral junction deformity: A report of two cases

Abstract

HighlightsThe surgical correction of the deformities of the craniovertebral junction (CVJ) remains a challenge due to its complex anatomy.A combined anterior-posterior approach is sometimes required, especially in patients with rigid CVJ deformities.Transoral anterior release assisted by CT navigation can be a safe and effective treatment option for rigid complex CVJ deformities.The identification of the patients’ anatomical features such as occipitoatlantal assimilation is crucial for accurate navigation.

Transoral Surgery for Irreducible Atlantoaxial Dislocation Complicated by Concomitant Aberrant Internal Carotid Arteries

“…3) As previously reported, enhanced CT-based navigation is a powerful tool in transoral anterior release surgery for detecting the anatomical location and the abnormal course of ICAs. 6) As an additional surgical guide and for safety, it was beneficial to evaluate the running courses of ICAs and the cerebral blood flow in real-time intraoperatively using pharyngeal ultrasonography, 7) cerebral angiography, 8) and near-infrared spectroscopy (NIRS). [9][10] When making an incision in the pharynx, color Doppler ultrasonography helped identify a safe surgical window.…”

Degenerative Cervical Myelopathy; A Review of the Latest Advances and Future Directions in Management

“…Despite the abundance of new technology in the application of robotics, minimally invasive surgery (MIS) and stereotactic navigation in spine surgery, very little has been published with regards to improving outcomes in DCM surgery. Stereotactic navigation has been used to improve the accuracy (and therefore safety) of both cervical pedicle and lateral mass screws, in addition to aiding anterior decompression in complex craniocervical junction cases [129-131]. Robotic-assisted devices utilize stereotactic navigation to aid with pedicle screw placement, but despite their increasing popularity in North America, they currently have no role in DCM surgery [132].…”