Abstract
Craniovertebral junction is a delicate region; any damage to vertebral artery (VA) or medullo-spinal cord junction may result in a life-threatening situation. We should have a meticulous dissection method with proper understanding of anatomy to obtain a wide and dry surgical field. The author would like to emphasize three significant points:
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1.
Too much use of an electrical scalpel is one of the risk factors to meet unpleasant bleeding from VA or dilated epidural venous plexus. Subperiosteal dissection is the key.
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Understanding of anatomical characteristics around epidural venous plexus will help you to know how to manage epidural venous plexus between C1 and C2.
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3.
Direct suction to the bleeding from venous plexus may tear the plexus wall more. Suction via saline soaked cotton pad is quite useful to arrest bleeding.
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Shimizu, T. (2019). Posterior Midline Approach C0–C2: How to Expose Meticulously with Less Bleeding. In: Koller, H., Robinson, Y. (eds) Cervical Spine Surgery: Standard and Advanced Techniques. Springer, Cham. https://doi.org/10.1007/978-3-319-93432-7_14
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DOI: https://doi.org/10.1007/978-3-319-93432-7_14
Publisher Name: Springer, Cham
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