Answer to the Letter to the Editor of A. Goel concerning “Clival screw and plate fixation by the transoral approach for the craniovertebral junction: a CT-based feasibility study” by Lin J, Kong G, Xu X, Liu Q, Huang Z, Zhu Q, and Ji W (Eur Spine J. 2019; doi:10.1007/s00586-019-06039-5)
We appreciate the letter from Prof. A. Goel, whose team had reported a patient with congenital basilar invagination after odontoidectomy in the year 1994, and the stability reconstruction was performed by a double compression stainless steel radio-ulnar fixation plate with screws place to the clivus and the body of the cervical vertebra . For the anterior occipitocervical reconstruction, except for the above fixation method, the modified titanium mesh was also applied . However, for the clival screw fixation, the anatomy of the clivus was unclear; furthermore, there was no specific instrumentation for the craniovertebral region anteriorly. Then, we conducted series anatomic studies for the clival screw placement . Based on those anatomic data, a novel clivus plate fixation system specific to craniovertebral region was developed, which was biomechanically prior to the conventional fixation techniques . Therefore, there are innovations in our series of works as stated above, and that will lay a foundation for the clinical application. Surely, in our previous studies, the researches of Dr. Goel’s team and studies related to the method of the modified titanium mesh were also quoted.