Significance of Multimodal Intraoperative Monitoring During Surgery in Patients with Craniovertebral Junction Pathology

Lee, Jung Jae; Hong, Jae Taek; Kim, Il Sup; Kwon, Jae Yeol; Lee, Jong Beom; Park, Jae Hyung

doi:10.1016/j.wneu.2018.07.092

Cited by 10 publications

(10 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, CSD surgery has a variety of approaches (anterior approach, posterior approach, simultaneous anteriorposterior approach, and 540° approach) because of the surrounding neurovascular structures, so expressing surgical grade of CSD surgery could be rather complicated. 15,19,20,[22][23][24]30 Recently, a classification system has been developed to standardize the description of cervical osteotomy types. 3 This system is a 7-point scale based on anatomical resections that are graded according to the potential for destabilization.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, most of thoracolumbar spine deformity can be treated by the posterior only surgery, so it could be simple to express the surgical grade of thoracolumbar deformity. However, CSD surgery has a variety of approaches (anterior approach, posterior approach, simultaneous anteriorposterior approach, and 540° approach) because of the surrounding neurovascular structures, so expressing surgical grade of CSD surgery could be rather complicated [ 15 , 19 , 20 , 22 - 24 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, surgical correction of CSD can be challenging not only because it often requires osteotomies to obtain adequate correction especially in the setting of rigid CSD, but also because the target of surgical correction is adjacent to the critical neurovascular structures. 8,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] Thus, the postoperative complications have been reported to be relatively high and the number of studies on CSD are far inferior to those of thoracolumbar deformity.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

SOF System; A New Nomenclature System for the Surgical Techniques of Cervical Spine Deformity

Hong

Koller

Abumi³

et al. 2020

Neurospine

Self Cite

View full text Add to dashboard Cite

Although cervical spinal deformity (CSD) can have a profoundly negative impact on an individual's quality of life and there have been many advances in surgical treatment of CSD in recent years, there exists no comprehensive classification system of surgical treatment that categorizes anterior and posterior surgery separately according to the grade of surgery. The objective of this study is to introduce the new classification system of various surgical treatments for CSD. We developed a new classification system (SOF system) for CSD surgery that describes the sequence of surgical approach (S), the grade of osteotomy (O), and the information of fixation (F) using alphanumeric codes. This new classification system can provide a consistent description of the various osteotomies performed in CSD surgery. Especially, regarding research, there has been a clear benefit to this classification. Having a standardized classification that allows for common frame for cervical deformity correction surgery, communication between surgeons and the evaluation of the CSD surgeries make it possible to conduct global comparative research about surgical outcome.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

SOF System; A New Nomenclature System for the Surgical Techniques of Cervical Spine Deformity

Hong

Koller

Abumi³

et al. 2020

Neurospine

Self Cite

View full text Add to dashboard Cite

show abstract

“…Even though several reports of vertical reduction technique showed excellent clinical and radiological results without neurological complication [ 21 , 37 , 43 , 44 ], we experienced cases with transient neurological worsening after craniocervical realignment and encountered several cases with a significant change in IONM during the vertical reduction technique [ 67 ]. To date, we are not sure whether it is related to spinal cord stretch or spinal cord ischemia due to the VA stretch.…”

Section: Treatment Of Craniovertebral Junction Deformitymentioning

confidence: 99%

“…IONM change is more common in CVJ surgery than at any other level of the cervical spine. Preoperative T2 signal change on MRI and narrow canal diameter are 2 risk factors that are significantly related to IONM change in our CVJ surgery case series [ 46 , 67 , 68 ]. We suggest that IONM may help in preventing unexpected neurological deterioration during posterior craniocervical distraction and realignment.…”

Section: Treatment Of Craniovertebral Junction Deformitymentioning

confidence: 99%

Evaluation and Surgical Planning for Craniovertebral Junction Deformity

et al. 2020

Self Cite

View full text Add to dashboard Cite

Craniovertebral junction (CVJ) deformity is a challenging pathology that can result in progressive deformity, myelopathy, severe neck pain, and functional disability, such as difficulty swallowing. Surgical management of CVJ deformity is complex for anatomical reasons; given the discreet relationships involved in the surrounding neurovascular structures and intricate biochemical issues, access to this region is relatively difficult. Evaluation of the reducibility, CVJ alignment, and direction of the mechanical compression may determine surgical strategy. If CVJ deformity is reducible, posterior in situ fixation may be a viable solution. If the deformity is rigid and the C1-2 facet is fixed, osteotomy may be necessary to make the C1-2 facet joint reducible. C1-2 facet release with vertical reduction technique could be useful, especially when the C1-2 facet joint is the primary pathology of CVJ kyphotic deformity or basilar invagination. The indications for transoral surgery are becoming as narrow as a treatment for CVJ deformity. In this article, we will discuss CVJ alignment and various strategies for the management of CVJ deformity and possible ways to prevent complications and improve surgical outcomes.

show abstract