4.

HighlightsThis is the case of a 64-year-old woman with VDRR and extensive spinal ossification.This case was followed up for over 30 years.Imaging studies demonstrated fusion of the entire spine below the C2 vertebra.Mobility at the craniovertebral junction caused C1-level spinal cord compression.The pathology mimicked ankylosing spondylitis.

HighlightsThe surgical correction of the deformities of the craniovertebral junction (CVJ) remains a challenge due to its complex anatomy.A combined anterior-posterior approach is sometimes required, especially in patients with rigid CVJ deformities.Transoral anterior release assisted by CT navigation can be a safe and effective treatment option for rigid complex CVJ deformities.The identification of the patients’ anatomical features such as occipitoatlantal assimilation is crucial for accurate navigation.