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Technical Advances in Pediatric Craniovertebral Junction Surgery

  • Mark E. Oppenlander
  • James Kalyvas
  • Volker K. H. Sonntag
  • Nicholas TheodoreEmail author
Chapter
First Online:
Part of the Advances and Technical Standards in Neurosurgery book series (NEUROSURGERY, volume 40)

Abstract

Surgery for conditions in the craniovertebral junction in the pediatric population poses unique challenges. The posterior approach has emerged as the gold standard for arthrodesis in this region. Anterior fixation or decompression also may be indicated. Intraoperative image guidance and neurophysiological monitoring improve the safety and efficacy of these procedures. The specific technical advances in surgery of the craniovertebral junction that have improved patient outcomes are reviewed.

Keywords

Craniovertebral junction surgery Pediatrics Arthrodesis Image guidance Neurophysiological monitoring 
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References

  1. 1.
    Ahmed R, Traynelis VC, Menezes AH (2008) Fusions at the craniovertebral junction. Childs Nerv Syst 24:1209–1224PubMedCrossRefGoogle Scholar
  2. 2.
    Anderson RC, Ragel BT, Mocco J et al (2007) Selection of a rigid internal fixation construct for stabilization at the craniovertebral junction in pediatric patients. J Neurosurg 107:36–42PubMedGoogle Scholar
  3. 3.
    Apostolides PJ (1998) Technique of transoral odontoidectomy. Oper Tech Neurosurg 1:58–62CrossRefGoogle Scholar
  4. 4.
    Braun V (2001) In vivo experiences with frameless stereotactically guided screw placement in the spine – results from 75 consecutive cases. Neurosurg Rev 24:74–79PubMedCrossRefGoogle Scholar
  5. 5.
    Brooks AL, Jenkins EB (1978) Atlanto-axial arthrodesis by the wedge compression method. J Bone Joint Surg Am 60:279–284PubMedGoogle Scholar
  6. 6.
    Dickman CA, Lekovic GP (2005) Biomechanical considerations for stabilization of the craniovertebral junction. Clin Neurosurg 52:205–213PubMedGoogle Scholar
  7. 7.
    Dickman CA, Sonntag VK, Papadopoulos SM et al (1991) The interspinous method of posterior atlantoaxial arthrodesis. J Neurosurg 74:190–198PubMedCrossRefGoogle Scholar
  8. 8.
    Dogan S, Safavi-Abbasi S, Theodore N et al (2006) Pediatric subaxial cervical spine injuries: origins, management, and outcome in 51 patients. Neurosurg Focus 20:E1PubMedCrossRefGoogle Scholar
  9. 9.
    Eleraky MA, Theodore N, Adams M et al (2000) Pediatric cervical spine injuries: report of 102 cases and review of the literature. J Neurosurg 92:12–17PubMedCrossRefGoogle Scholar
  10. 10.
    Haque A, Price AV, Sklar FH et al (2009) Screw fixation of the upper cervical spine in the pediatric population. Clinical article. J Neurosurg Pediatr 3:529–533PubMedCrossRefGoogle Scholar
  11. 11.
    Hedequist D, Proctor M (2009) Screw fixation to C2 in children: a case series and technical report. J Pediatr Orthop 29:21–25PubMedCrossRefGoogle Scholar
  12. 12.
    Kanavel AB (1919) Bullet locked between atlas and the base of the skull: technique for removal through the mouth. Surg Clin 1:361–6Google Scholar
  13. 13.
    Knott PT, Mardjetko SM, Kim RH et al (2010) A comparison of magnetic and radiographic imaging artifact after using three types of metal rods: stainless steel, titanium, and vitallium. Spine J 10:789–794PubMedCrossRefGoogle Scholar
  14. 14.
    Ludwig SC, Kramer DL, Vaccaro AR et al (1999) Transpedicle screw fixation of the cervical spine. Clin Orthop Relat Res 359:77–88PubMedCrossRefGoogle Scholar
  15. 15.
    MacKenzie AI, Uttley D, Marsh HT et al (1990) Craniocervical stabilization using Luque/Hartshill rectangles. Neurosurgery 26:32–36PubMedCrossRefGoogle Scholar
  16. 16.
    Magerl F, Seemann PS (1987) Stable posterior fusion of the atlas and axis by transarticular screw fixation. In: Kehr WA, Weidner A (eds) Cervical spine I, vol 1. Springer, New York, pp 322–327CrossRefGoogle Scholar
  17. 17.
    Melcher RP, Puttlitz CM, Kleinstueck FS et al (2002) Biomechanical testing of posterior atlantoaxial fixation techniques. Spine (Phila Pa 1976) 27:2435–2440CrossRefGoogle Scholar
  18. 18.
    Paramore CG, Dickman CA, Sonntag VK (1996) The anatomical suitability of the C1-2 complex for transarticular screw fixation. J Neurosurg 85:221–224PubMedCrossRefGoogle Scholar
  19. 19.
    Quraishi NA, Lewis SJ, Kelleher MO et al (2009) Intraoperative multimodality monitoring in adult spinal deformity: analysis of a prospective series of one hundred two cases with independent evaluation. Spine (Phila Pa 1976) 34:1504–1512CrossRefGoogle Scholar
  20. 20.
    Rajasekaran S, Kanna PR, Shetty AP (2012) Safety of cervical pedicle screw insertion in children – a clinico-radiological evaluation of computer assisted insertion of 51 cervical pedicle screws including 28 Sub-axial pedicle screws in sixteen children. Spine (Phila Pa 1976) 37:E216–E223CrossRefGoogle Scholar
  21. 21.
    Schultz KD Jr, Petronio J, Haid RW et al (2000) Pediatric occipitocervical arthrodesis. A review of current options and early evaluation of rigid internal fixation techniques. Pediatr Neurosurg 33:169–181PubMedCrossRefGoogle Scholar
  22. 22.
    Sonntag VK, Dickman CA (1993) Craniocervical stabilization. Clin Neurosurg 40:243–272PubMedGoogle Scholar
  23. 23.
    Thuet ED, Winscher JC, Padberg AM et al (2010) Validity and reliability of intraoperative monitoring in pediatric spinal deformity surgery: a 23-year experience of 3436 surgical cases. Spine (Phila Pa 1976) 35:1880–1886CrossRefGoogle Scholar
  24. 24.
    Tuite GF, Veres R, Crockard HA et al (1996) Pediatric transoral surgery: indications, complications, and long-term outcome. J Neurosurg 84:573–583PubMedCrossRefGoogle Scholar
  25. 25.
    Veres R, Bago A, Fedorcsak I (2001) Early experiences with image-guided transoral surgery for the pathologies of the upper cervical spine. Spine (Phila Pa 1976) 26:1385–1388CrossRefGoogle Scholar
  26. 26.
    Welch WC, Subach BR, Pollack IF et al (1997) Frameless stereotactic guidance for surgery of the upper cervical spine. Neurosurgery 40:958–963PubMedCrossRefGoogle Scholar
  27. 27.
    Wright NM (2004) Posterior C2 fixation using bilateral, crossing C2 laminar screws: case series and technical note. J Spinal Disord Tech 17:158–162PubMedCrossRefGoogle Scholar
  28. 28.
    Youssef AS, Guiot B, Black K et al (2008) Modifications of the transoral approach to the craniovertebral junction: anatomic study and clinical correlations. Neurosurgery 62:145–154PubMedCrossRefGoogle Scholar
  29. 29.
    Zeller R, Canavese F, Kulkarni AV et al (2009) Technique for drilling instrument monitoring electrical conductivity in pediatric cervical spine screw insertion: a preliminary report. J Pediatr Orthop 29:760–764PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Mark E. Oppenlander
    • 1
  • James Kalyvas
    • 1
  • Volker K. H. Sonntag
    • 1
  • Nicholas Theodore
    • 1
    Email author
  1. 1.Division of Neurological SurgeryBarrow Neurological Institute, St. Joseph’s Hospital and Medical CenterPhoenixUSA

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