Acta Chir Orthop Traumatol Cech. 2009; 76(2):137-148 | DOI: 10.55095/achot2009/027
Navigation Techniques in Surgery of Cranio-Cervical Junction and Upper Cervical SpineCurrent concepts review
- Neurocentrum, Krajská nemocnice Liberec, a.s.
Spinal navigation has substantially advanced during the past ten years. Surgeons have gained sufficient skills and confidence, and have introduced this technology to the anatomically challenging region of the upper cervical spine and craniocervical junction. The detailed evaluation of individual anatomy, rational pre-operative planning and final intraoperative control improve the safety and precision of classical surgical procedures.
As methods technologically evolve, indication criteria change accordingly, but the basic principles of a relevatn choice remain; these are to reduce morbidity due to its three main causes, i.e., mechanical, neurological and vascular. We present an overview of current techniques and discuss their applicability in the region of the upper cervical spine and craniocervical junction. The systems allowing us to obtain "live" images intra-operatively, such as fluoroscopy or intra-operative CT, seem to be most versatile and accurate, especially when combined with "traditional" virtual navigation systems.
Based on case histories, the authors suggest trends in the development of this field, with a focus on minimally invasive techniques.
Keywords: navigation, upper cervical spine, craniocervical junction
Published: April 1, 2009 Show citation
ACS | AIP | APA | ASA | Harvard | Chicago | Chicago Notes | IEEE | ISO690 | MLA | NLM | Turabian | Vancouver |
References
- BARSA, P., SUCHOMEL, P., LUKÁŠ, R., TALLER, S., ENDRYCH, L.: Perkutální CT-navigovaná radiofrekvenční ablace v terapii spinálních osteoidních osteomů. Acta Chir. ortop., Traum. čech., 74: 401-405, 2007.
Go to original source...
- BLOCH, O., HOLLY, L. T., PARK, J., OBASI, C., KIM, K., JOHNSON, J.P.: Effect of frameless stereotaxy on the accuracy of C1-2 transarticular screw placement. J. Neurosurg., 95: 74-79, 2001.
Go to original source...
Go to PubMed...
- CACCIOLA, F., UMESH, P., GOEL, A.: Vertebral artery in relationship to C1-C2 vertebra: an anatomical study. Neurol. India, 52: 178-184, 2004.
- VAN CLEYNENBREUGEL, J., SCHUTYSER, F., GOFFIN, J., VAN BRUSSEL, K., SUETENS P.: Image-Based Planning and Validation of C1-C2 Transarticular Screw Fixation Using Personalized Drill Guides. Computed Aided Surgery, 7: 41-48, 2002.
Go to original source...
- DOHERTY, B. J., HEGGENESS, M. H.: The Quantitative Anatomy of the Atlas. Spine, 19: 2497-2500, 1994.
Go to original source...
Go to PubMed...
- ECK, J. C., WALKER, M. P., CURRIER, B. L., CHEN, Q., YASZEMSKI, M. J., AN, K. N.: Biomechanical Comparison of Unicortical Versus Bicortical C1 Lateral Mass Screw Fixation. J. Spinal Disord. Tech., 20: 505-508, 2007.
Go to original source...
Go to PubMed...
- EBRAHEIM, N. A., MISSON, J. R., XU, R., YEASTING, R. A.: The Optimal Transarticular c1-2 Screw Length and the Location of the Hypoglossal Nerve. Surg., Neurol., 53: 208-10, 2000.
Go to original source...
Go to PubMed...
- FOLEY, K. T., SMITH, M. M.: Image-Guided Spine Surgery. Neurosurg. Clin. N. Amer., 7: 171-186, 1996.
Go to original source...
- GEBHARD, F., WEIDNER, A., LIENER, U. C., STÖCKLE, U., ARAND, M.: Navigation at the spine. Int. J. Care Injured., 35: S-A35 - S-A45, 2004.
Go to original source...
- GLUF, W. M., SCHMIDT, M. H., APPELBAUM, R. I.: Atlantoaxial transarticular screw fixation: a review of surgical indications, fusion rate, complications, and lessons learned in 191 adult patients. J. Neurosurg. Spine, 2: 155-163, 2005.
Go to original source...
Go to PubMed...
- GOEL, A., LAHERI, V.: Plate and screw fixation for atlanto-axial subluxation. Acta Neurochir., 129: 47-53, 1994.
Go to original source...
Go to PubMed...
- GOFFIN, J., BRUSSEL, K. V., MARTENS, K., SLOTEN J. V., AUDEKERCKE, R. V., SMET, M. H.: Three-Dimensional Computed Tomography-Based, Personalized Drill Guide for Posterior Cervical Stabilization at C1-C2. Spine, 26: 1343-1347, 2001.
Go to original source...
Go to PubMed...
- GROB, D., JEANNERET, B., AEBI, M.: Atlanto-axial fusion with transarticular scre fixation. J. Bone Jt Surg., 73: 972-976, 1991.
Go to original source...
Go to PubMed...
- HARMS, J., MELCHER, R. P.: Posterior C1-C2 fusion with polyaxial screw and rod fixation. Spine, 26: 2467-71, 2001.
Go to original source...
Go to PubMed...
- HOLLY, L. T.: Image-guided spinal surgery. Int. J. Med. Robotics Comput. Assist. Surg., 2: 7-15, 2006.
Go to original source...
Go to PubMed...
- HOLLY, L. T., FOLEY, K. T.: Percutaneous Placement of Posterior Cervical Screws Using Three-Dimensional Fluoroscopy. Spine, 31: 536-540, 2006.
Go to original source...
Go to PubMed...
- JOLESZ, F. A.: Future perspectives for intraoperative MRI. Neurosurg. Clin. N. Amer. 16: 201-213, 2005.
Go to original source...
Go to PubMed...
- JUDET, R., ROY-CAMILLE, R., SAILLANT, G.: Fractures du raches cervical. Actualités de chirurgie orthopédique de l'hospital Raymond-Poincaré, 8: 174-175, 1970.
- KANDZIORA, F., SCHULZE-STAHL, N., KHODADADYAN-KLOSTERMANN, C., SCHRÖDER, R., MITTLMEIER, T.: Screw placement in transoral atlantoaxial plate systems: an anatomical study. J. Neurosurg. Spine, 95: 80-87, 2001.
Go to original source...
Go to PubMed...
- KOLLER, H., KAMMERMEIER, V., ULBRICHT, D., ASSUNCAO, A., KAROLUS, S., BERG, B., HOLZ, U.: Anterior retropharyngeal fixation C1-2 for stabilization of atlantoaxial instabilities: study of feasibility, technical description and preliminary results. Europ. Spine J., 15: 1326-1338, 2006.
Go to original source...
Go to PubMed...
- MADAWI, A. A., CASEY, A. T., SOLANKI, G. A., TUITE, G., VERES, R., CROCKARD, H. A.: Radiological and anatomical evaluation of the atlantoaxial transarticular screw fixation technique. J. Neurosurg., 86: 961-968, 1997.
Go to original source...
Go to PubMed...
- MADAWI, A. A., SOLANKI, G., CASEY, A. T., CROCKARD, H. A.: Variation of the groove in the axis vertebra for the vertebral artery. Implications for instrumentation. J. Bone Jt Surg., 79-B: 820-3, 1997.
Go to original source...
- MAGERL, F., SEEMANN, P. S.: Stable posterior fusion of the atlas and axis by transarticular screw fixation. In: Kehr P., Weidner A., eds.: Cervical spine. Wien, Springer-Verlag 1986, 322-327.
Go to original source...
- MANDEL, I. M., KAMBACH, B. J., PETERSILGE, CH. A., JOHNSTONE, B., YOO, J. U.: Morphologic Considerations of C2 Isthmus Dimensions for the Placement of Transarticular Screws. Spine, 25: 1542-1547, 2000.
Go to original source...
Go to PubMed...
- PARAMORE, C. G., DICKMAN, C. A., SONNTAG, V. K.: The anatomical suitability of the C1-2 complex for transarticular screw fixation. J. Neurosurg., 85: 221-224, 1996.
Go to original source...
Go to PubMed...
- RAJASEKARAN, S., VIDYADHARA, S., SHETTY, A. P.: Iso-C 3D Fluoroscopy-based Navigation in Direct Pedicle Screw Fixation of Hangman Fracture. J. Spinal Disord. tech., 20: 616-619, 2007.
Go to original source...
Go to PubMed...
- RESNICK, D. K., LAPSIWALA, S., TROST, G.: Anatomic Suitability of the C1-C2 Complex for Pedicle Screw Fixation. Spine, 27: 1494-1498, 2002.
Go to original source...
Go to PubMed...
- SUCHOMEL, P., BUCHVALD, P., BARSA, P., FROEHLICH, R., CHOUTKA, O., KREJZAR, Z., SOURKOVÁ, P., ENDRYCH, L., DZAN, L.: Single-stage total C-2 intralesional spondylectomy for chordoma with three-column reconstruction. J. Neurosurg. Spine, 6: 611-618, 2007.
Go to original source...
Go to PubMed...
- SUCHOMEL, P., BUCHVALD, P., BARSA, P., LUKAS, R., SOUKUP, T.: Pyogenic Osteomyelitis of the Odontoid Process: Single Stage Decompression and Fusion. Spine, 28: 1-6, 2003.
Go to original source...
Go to PubMed...
- ŠTULÍK, J., SUCHOMEL, P., LUKÁŠ, R., CHROBOK, J., KLÉZL, Z., TALLER, S., KRBEC, M.: Přímá osteosyntéza dentu - multicentrická studie. Acta Chir. ortop. Traum. čech., 69: 141-148, 2002.
- ŠTULÍK, J., ŠEBESTA, P., VYSKOČIL, T., KRYL, J.: Zlomeniny dentu u pacientů nad 65 let: přímá osteosyntéza dentu vs. zadní fixace C1-C2. Acta Chir. ortop. Traum. čech., 75: 99-105, 2008
Go to original source...
- ŠTULÍK, J., KOZÁK, J., ŠEBESTA, P., VYSKOČIL, T., KRYL, J., PELICHOVSKÁ, M.: Total Spondylectomy of C2: a New Surgical Technique. Acta Chir. ortop. Traum. čech., 74: 79-90, 2007
Go to original source...
- TALLER, S., SUCHOMEL, P., LUKÁŠ, R., BERAN, J.: CT-guided internal fixation of a hangman's fracture. Europ. Spine J., 9: 393-397, 2000.
Go to original source...
Go to PubMed...
- WOODARD, E. J., LEON, S. P., MORIARTY, T. M., QUINONES, A., ZAMANI, A. A., JOLESZ, F. A.: Initial Experience With Intraoperative Magnetic Resonance Imaging in Spine Surgery. Spine, 26: 410-417, 2001.
Go to original source...
Go to PubMed...
- WRIGHT, N. M.: Translaminar rigid screw fixation of the axis. J. Neurosurg. Spine, 3: 409-414, 2005.
Go to original source...
Go to PubMed...
- WRIGHT, N. M., LAURYSSEN, C.: Vertebral artery injury in C1-2 transarticular screw fixation: results of a survey of the AANS/CNS section on disorders of the spine and peripheral nerves. J. Neurosurg., 88: 634-640, 1998.
Go to original source...
Go to PubMed...
- YOSHIDA, M., NEO, M., FUJIBAYASHI, S., NAKAMURA, T.: Comparison of the Anatomical Risk for Vertebral Artery Injury Associated With the C2-Pedicle Screw and Atlantoaxial Transarticular Screw. Spine, 31: E513-E517, 2006.
Go to original source...
Go to PubMed...