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Relevant Anatomy of the Craniovertebral Junction

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Surgery of the Cranio-Vertebral Junction

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Abstract

Objectives. 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 and upper spinal nerves, the caudal brainstem and rostral spinal cord, the vertebral arteries and their branches, the venous drainages through the jugular vein, and the vertebral plexus. The objective of this chapter is to provide a 360° description of the relevant microsurgical and endoscopic anatomy of the CVJ.

Materials and Methods. Cadaveric dissections were performed, and anatomical observations were made with the aid of a surgical microscope and of a 0- and 30-degree rod-lens endoscopes. Three-dimensional (3D) models were reconstructed, using dedicated software, from the anatomical images of the head of The National Library of Medicine’s Visible Human Project.

Results. The relevant anatomy of the CVJ was explored through (1) a posteromedial perspective directed at the squamosal part of the occipital bone and the middle part of the posterior arch of C1; (2) a posterolateral perspective focused on the condylar part of the occipital bone, lateral mass of C1 and C2; (3) an anterolateral perspective directed to the jugular foramen, transverse process of C1 and C2; (4) an anteromedial perspective that provides exposure of the clival portion of occipital bone, anterior arch of C1, and odontoid process.

Conclusions. Description of the relevant anatomy of the CVJ with a 360° anatomical perspective upgraded with 3D models may provide anatomical information more readily applicable to the operative setting.

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Authors and Affiliations

  1. Division of Neurosurgery, Department of Neurosciences and Reproductive and Odontostomatological Sciences, Università di Napoli “Federico II”, Naples, Italy

    Elena d’Avella, Luigi Maria Cavallo & Paolo Cappabianca

  2. Neurosurgery Operative Unit, Department of Neurosciences, “G.Rummo” Hospital, Benevento, Italy

    Matteo De Notaris

  3. Laboratory of Surgical NeuroAnatomy (LSNA), Human Anatomy and Embriology Unit, Faculty of Medicine, Universidad de Barcelona, Barcelona, Spain

    Jose Pineda & Alberto Prats-Galino

  4. Institut Clínic de Neurociències (ICN), Department of Neurological Surgery Hospital Clínic de Barcelona, Universidad de Barcelona, Barcelona, Spain

    Alberto Di Somma

Authors
  1. Elena d’Avella
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  2. Luigi Maria Cavallo
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  3. Matteo De Notaris
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  4. Jose Pineda
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  6. Paolo Cappabianca
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  7. Alberto Prats-Galino
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Editor information

Editors and Affiliations

  1. Neurosurgical Unit, Geneva University Hospitals, Geneva, Switzerland

    Enrico Tessitore

  2. Department of Neurosurgery, North Shore University Hospitals, Manhasset, NY, USA

    Amir R. Dehdashti

  3. Neurosurgical Unit, ASL Napoli 2 Nord, Naples, Italy

    Claudio Schonauer

  4. Department of Neurosurgery, Innsbruck University Hospitals, Innsbruck, Austria

    Claudius Thomé

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d’Avella, E. et al. (2020). Relevant Anatomy of the Craniovertebral Junction. In: Tessitore, E., Dehdashti, A., Schonauer, C., Thomé, C. (eds) Surgery of the Cranio-Vertebral Junction. Springer, Cham. https://doi.org/10.1007/978-3-030-18700-2_1

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  • DOI: https://doi.org/10.1007/978-3-030-18700-2_1

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  • Online ISBN: 978-3-030-18700-2

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