Journal
FRONTIERS IN SURGERY
Volume 9, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fsurg.2022.984015
Keywords
endoscope-assisted surgery; high anterior cervical approach; craniovertebral junction; endoscopic technique; application
Categories
Funding
- National Science Foundation of China [30901774]
- Natural Science Foundation of Shanxi Province [2014011038-2]
- Shanxi Province Science and Technology Development Plan (Social Development Section) [20140313011-5]
- Key R&D Plan of Shanxi Province (International Cooperation Project) [201803D421055]
- Shanxi Province Overseas Students Science and Technology Activities Selection Funding Project [2018014]
- Scientific research projects with provincial special funds in Shanxi Provincial People's Hospital [sj20019003]
- Fundamental Research Program of Shanxi Province [20210302123352]
- Shanxi Province Health Commission Scientific Research Project [2022052]
- Shanxi Scholarship Council of China [2022-205]
- Four Batches Innovation Project of Invigorating Medical through Science and Technology of Shanxi Province
- [2022XM21]
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This study explores the feasibility of an endoscopy-assisted high anterior cervical approach in the craniovertebral junction (CVJ), and finds that this method provides adequate exposure and minimizes the risk of neurovascular injury.
BackgroundSurgical procedures in the craniovertebral junction (CVJ) suffer from specific challenges due to the proximity between the cranium and spine containing the critical neurovascular structures and the brainstem, respectively. Owing to the complex transitional zone, it is highly challenging for classic surgical approaches to practically acquire the additional exposure to neurovascular structures of the CVJ. Inspired by these facts, we explore the feasibility of an endoscopy-assisted high anterior cervical approach in the CVJ. MethodsTo explore the feasibility of an endoscopy-assisted approach, we quantitatively assessed the surgical corridor and extent of exposure of the CVJ in 6 cadaveric specimens using 0 degrees and 30 degrees endoscopes. ResultsThe applied endoscopes provided adequate exposure to neurovascular structures and the brainstem in the CVJ. Notably, the resection of the anterior arch of C1 is avoided in minimal anterior clivectomy. Further, improved exposure of the CVJ is obtained after removing the odontoid. ConclusionAn endoscope-assisted high anterior cervical approach in the CVJ significantly preserved the cervical spine stability while minimalizing the risk of neurovascular injury within the surgical corridor.
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