Chen Qi, Brahimaj Bledi C, Khanna Ryan, Kerolus Mena G, Tan Lee A, David Brian T, Fessler Richard G
Department of Neurosurgery, Rush University Medical Center, Chicago, IL, USA.
Department of Neurosurgery, UCSF Medical Center, San Francisco, CA, USA.
J Spine Surg. 2020 Mar;6(1):164-180. doi: 10.21037/jss.2020.03.05.
Posterior atlantoaxial fusion is an important surgical technique frequently used to treat various pathologies involving the cervical 1-2 joint. Since the beginning of the 20th century, various fusion techniques have been developed with improved safety profile, higher fusion rates, and superior clinical outcome. Despite the advancement of technology and surgical techniques, posterior C1-2 fusion is still a technically challenging procedure given the complex bony and neurovascular anatomy in the craniovertebral junction (CVJ). In addition, vascular anomalies in this region are not uncommon and can lead to devastating neurovascular complications if unrecognized. Thus, it is important for spine surgeons to be familiar with various posterior atlantoaxial fusion techniques along with a thorough knowledge of various vascular anomalies in the CVJ. Intimate knowledge of the various surgical techniques in combination with an appreciation for anatomical variances, allows the surgeon develop a customized surgical plan tailored to each patient's particular pathology and individual anatomy. In this article, we aim to provide a comprehensive review of existing posterior C1-2 fusion techniques along with a review of common vascular anomalies in the CVJ.
寰枢椎后路融合术是一种重要的外科技术，常用于治疗涉及颈1-2关节的各种病变。自20世纪初以来，已开发出各种融合技术，其安全性更高、融合率更高且临床效果更佳。尽管技术和手术技术有所进步，但鉴于颅颈交界区（CVJ）复杂的骨骼和神经血管解剖结构，寰枢椎后路融合术仍然是一项具有技术挑战性的手术。此外，该区域的血管异常并不罕见，如果未被识别，可能会导致毁灭性的神经血管并发症。因此，脊柱外科医生熟悉各种寰枢椎后路融合技术以及全面了解CVJ中的各种血管异常非常重要。深入了解各种手术技术并认识到解剖变异，有助于外科医生制定针对每个患者特定病变和个体解剖结构的定制手术计划。在本文中，我们旨在对现有的寰枢椎后路融合技术进行全面综述，并对CVJ中的常见血管异常进行综述。
