Acta Neurochirurgica

, Volume 159, Issue 10, pp 1919–1923 | Cite as

How I do it? Cranial setup for cranial settling

  • Eugenio Cárdenas Ruiz-ValdepeñasEmail author
  • A. Kaen
  • G. Perez Prat
How I Do it - Neurosurgical Techniques



Expanded endonasal endoscopic techniques allow us to treat several pathologies related to the odontoid process and craniocervical junction. Cases such as giant basilar invagination represent a surgical challenge.


The authors provide technical nuances and describe how to complete an endoscopic endonasal odontoidectomy and release the craniocervical junction with the aim of restoring a correct sagittal balance in cases with giant basilar invagination. The study of cadaveric specimens adds clarifying dissections.


Endonasal endoscopic odontoidectomy and craniocervical junction joint release allow the treatment of irreducible basilar invagination and restoration of better sagittal balance before posterior cervical occipitocervical fusion.


Endoscopic Endonasal Odontoidectomy Odontoid process Basilar impression Basilar invagination Dens Cranial settling 


Compliance with ethical standards


The authors report no financial disclosures.

Supplementary material


A video with the necessary steps to complete an endonasal endoscopic odontoidectomy as well as to disarticulate the craniocervical junction is attached. This video includes parts of different patients adding those where each concept is most clearly seen. (MP4 22,788 kb)


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Copyright information

© Springer-Verlag Wien 2017

Authors and Affiliations

  1. 1.Department of Neurological SurgeryHospital Virgen Del RocíoSevillaSpain

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