Atlas of Craniocervical Junction and Cervical Spine Surgery

229 Pages·2017·28.13 MB·English

by  Stefano Boriani

Stefano Boriani · Livio Presutti
Alessandro Gasbarrini
Francesco Mattioli Editors
Atlas of Craniocervical
Junction and
Cervical Spine Surgery
123
Atlas of Craniocervical Junction and Cervical
Spine Surgery
Stefano Boriani • Livio Presutti
Alessandro Gasbarrini • Francesco Mattioli
Editors
Atlas of Craniocervical
Junction and Cervical Spine
Surgery
Editors
Stefano Boriani Alessandro Gasbarrini
Bologna Bologna
Italy Italy
Livio Presutti Francesco Mattioli
Modena University Hospital of Modena
Italy Modena
Italy
ISBN 978-3-319-42735-5 ISBN 978-3-319-42737-9 (eBook)
DOI 10.1007/978-3-319-42737-9
Library of Congress Control Number: 2017939173
© Springer International Publishing Switzerland 2017
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Acknowledgment
The Authors are indebted and thank Carlo Piovani for his strenuous activity as anatomical
artist and for imaging collection and elaboration. Thanks to him we could select the most
attractive and demonstrating images and clarify the details of surgical anatomy.
v
Contents
Part I Anatomy
1 Anatomy of Craniocervical Junction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
M. Alicandri-Ciufelli, M. Menichetti, M.P. Alberici, and L. Presutti
2 Anatomy of the Subaxial Cervical Spine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
M. Girolami, R. Ghermandi, M. Ghirelli, A. Gasbarrini, and S. Boriani
3 Anatomy of the Neck . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
M. Bonali, D. Soloperto, E. Aggazzotti Cavazza, M. Ghirelli, and L. Presutti
Part II Planning
4 Interventional Radiology: Presurgical Selective Angiographic
Embolization (SAE) in Hypervascular Cervical Spine Tumours . . . . . . . . . . . . . . 49
Luigi Simonetti, Carlotta Barbara, Salvatore Isceri, and Elena Mengozzi
5 Anesthesiological Management and Patient Positioning . . . . . . . . . . . . . . . . . . . . 63
M.R. Bacchin, M. Di Fiore, Y.E. Akman, M. Girolami, R. Ghermandi,
A. Gasbarrini, and S. Boriani
6 Cervical Spine Instrumentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
M. Girolami, R. Ghermandi, A. Gasbarrini, Y.E. Akman, and S. Boriani
7 Tracheotomy Surgical Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
M. Ghirelli, F. Mattioli, G. Molinari, I. Cena, and L. Presutti
8 Surgical Planning in Cervical Spine Oncologic Patients . . . . . . . . . . . . . . . . . . . . . 95
S. Boriani, R. Ghermandi, M. Girolami, and A. Gasbarrini
Part III Surgical Approaches
9 Surgical Approaches to CCJ (Endoscopic Transnasal-
Transoral-Transcervical and Robotic Transoral Approach) . . . . . . . . . . . . . . . . 105
F. Mattioli, G. Molteni, M. Bettini, E. Cigarini, and L. Presutti
10 Anterior and Lateral Approaches to Cervical Spine . . . . . . . . . . . . . . . . . . . . . . . 129
M. Ghirelli, F. Mattioli, G. Molinari, and L. Presutti
11 Posterior Approach to Cervical Spine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175
R. Ghermandi, M. Girolami, A. Gasbarrini, and S. Boriani
12 Exemplificative Cases in Cervical Spine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
A. Gasbarrini, M. Girolami, R. Ghermandi, Y.E. Akman, and S. Boriani
13 Complications of Cervical Spine Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 217
Gabriele Molteni, Marco Giuseppe Greco, and Pierre Guarino
vii
Contributors
Elisa Aggazzotti Cavazza Otorhinolaryngology, Head and Neck Surgery Department,
University Hospital of Modena, Modena, Italy
Yunus Emre Akman Orthopaedics and Traumatology Department, Metin Sabanci
Baltalimani Bone Diseases Training and Research Hospital, Istanbul, Turkey
Maria Paola Alberici Head and Neck Surgery Department, University Hospital of Modena,
Modena, Italy
Ciufelli Matteo Alicandri Head and Neck Surgery Department, University Hospital of
Modena, Modena, Italy
Maria Renata Bacchin Rizzoli Orthopedic Institute, Bologna, Italy
Carlotta Barbara Emergency Interventional Unit, Ospedale Maggiore, Bologna, Italy
Margherita Bettini Head and Neck Surgery Department, University Hospital of Modena,
Modena, Italy
Marco Bonali Otorhinolaryngology, Head and Neck Surgery Department, University Hospital
of Modena, Modena, Italy
Stefano Boriani Oncologic and Degenerative Spine Surgery Department Rizzoli Orthopedic
Institute, Bologna, Italy
Isida Cena Head and Neck Surgery Department, University Hospital of Modena, Modena,
Italy
Elisa Cigarini Head and Neck Surgery Department, University Hospital of Modena, Modena,
Italy
Maria Di Fiore Rizzoli Orthopedic Institute, Bologna, Italy
Alessandro Gasbarrini Oncologic and Degenerative Spine Surgery Department Rizzoli
Orthopedic Institute, Bologna, Italy
Riccardo Ghermandi Oncologic and Degenerative Spine Surgery Department Rizzoli
Orthopedic Institute, Bologna, Italy
Michael Ghirelli Otorhinolaryngology, Head and Neck Surgery Department, University
Hospital of Modena, Modena, Italy
Marco Girolami Oncologic and Degenerative Spine Surgery Department Rizzoli Orthopedic
Institute, Bologna, Italy
Marco Giuseppe Greco Ent Department University Hospital of Modena, Modena, Italy
Pierre Guarino Head and Neck Surgery Department, University Hospital of Modena,
Modena, Italy
Salvatore Isceri Emergency Interventional Unit, Ospedale Maggiore, Bologna, Italy
ix
x Contributors
Francesco Mattioli Head and Neck Surgery Department, University Hospital of Modena,
Modena, Italy
Elena Mengozzi Emergency Interventional Unit, Ospedale Maggiore, Bologna, Italy
Marcella Menichetti Head and Neck Surgery Department, University Hospital of Modena,
Modena, Italy
Giulia Molinari Head and Neck Surgery Department, University Hospital of Modena,
Modena, Italy
Gabriele Molteni Department of Otolaryngology-Head and Neck Surgery, University
Hospital of Modena, Modena, Italy
Livio Presutti Otorhinolaryngology, Head and Neck Surgery Department,
Azienda Ospedaliera Universitaria Integrata, University Hospital of Verona, Modena, Italy
Luigi Simonetti Emergency Interventional Unit, Ospedale Maggiore, Bologna, Italy
D. Soloperto Otorhinolaryngology, Head and Neck Surgery Department, University Hospital
of Verona, Verona, Italy
P. Zambito, MD ENT Department University Hospital of Verona, Modena, Italy
Part I
Anatomy
Anatomy of Craniocervical Junction 1
M. Alicandri-Ciufelli, M. Menichetti, M.P. Alberici,
and L. Presutti
1.1 Osseous Anatomy 1. The squamosal portion, located in the dorsal aspect of
foramen magnum
The craniocervical junction (CCJ) is an osteoligamentous 2. The basal or clival portion located anterior to the foramen
complex between the occiput, atlas and axis, which provides magnum
both structural stability and movement [1]. 3. The condylar part that connects the squamosal and the
clival parts [4]
1.1.1 Occipital Bone The most posterior margin of the foramen magnum is
called the opisthion. The most anterior midline of the fora-
The occipital bone extends from the clivus anteriorly to the men magnum is termed the basion. The sagittal diameter
lambdoid suture posteriorly, its embryologic origin being of the foramen magnum should be 35 ± 4 mm. The trans-
four primary cartilaginous centres laid down in the chondro- verse diameter at the equator of foramen magnum is
cranium around the foramen magnum, and a fifth membra- slightly less.
nous element [2]. The superior nuchal line serves as a rough The condylar part includes the occipital condyles,
guide for the location of the transverse sinus, and the inion, which fall just at the level and anterior to the equator of
found in the midline along this line, approximates the torcular the foramen magnum. The shape of these condyles posi-
herophili. The insertion of the semispinalis capitis may be the tioned on either side of the foramen magnum allows the
most accurate landmark for the confluence of the sinuses [3]. skull to articulate with the cervical spine, whilst the angles
A fundamental anatomical part of the occipital bone is the prevent excessive axial rotation at the craniocervical
foramen magnum, which has three parts: junction [5].
M. Alicandri-Ciufelli (*) • M. Menichetti • M.P. Alberici
L. Presutti
Head and Neck Surgery Department, University Hospital of
Modena, Modena, Italy
e-mail: [email protected]
© Springer International Publishing Switzerland 2017 3
S. Boriani et al. (eds.), Atlas of Craniocervical Junction and Cervical Spine Surgery, DOI 10.1007/978-3-319-42737-9_1