Surgery of the Cranio-Vertebral Junction

I Introduction.- Relevant anatomy.- Anatomy of the VA at CVJ- Radiological assessment of CVJ.- Biomechanics of CVJ.- Sagittal balance concept applied to CVJ.- II General principles of CVJ surgery.- Surgical positioning.- Anesthesiological considerations.- Perioperative management.- III Surgical techniques.- Anterior approaches.- Posterior approaches.- Posterolateral approaches.- Transfacial approaches.- Transcranial approaches.- Transpetrosal approaches.- MIS techniques for CVJ.- Image-guidance and navigation.- Spinal fusion and bone harvesting.- Endovascular procedures.- IV Management of CVJ lesions.- Trauma of the CVJ.- Tumors of the CVJ.- Vascular pathologies of the CVJ.- Malformations of the CVJ.- Infections and metabolic diseases.

This book provides a unique tool for approaching cranio-vertebral junction (CVJ) surgery. Following a brief introduction to the relevant anatomy and biomechanics of CVJ, it explores the field of cranio-vertebral junction lesions and their management. Furthermore, individual chapters cover endovascular surgery, endoscopic skull base techniques, navigation and robotics, ensuring that surgeons stay up-to-date. A chapter addressing the consequences of CVJ surgery with regard to sagittal balance is of particular importance. The book is structured according both to the type of lesion involving the CVJ (tumor, trauma), and to the type of surgical approach (anterior, posterior). Further, it reflects innovative treatment modalities that have improved patient safety and efficacy rates for surgery involving the CVJ, and covers both open and minimally invasive surgical methods, enabling surgeons to hone their skills in both areas.

Author Information

Enrico Tessitore, MD, PD, is the Deputy Chairman of the Neurosurgical Unit at the Geneva University Hospitals in Switzerland, and he is Privat Docent at the Medical School of the University of Geneva. He is Co-Director of the Cancer Center of Geneva University Hospital and responsible for bone metastasis Tumor Board. He's been trained in Naples (Italy) and then moved to Geneva, where he completed the residency program. Dr. Tessitore has significant clinical expertise in performing spinal surgical procedures for degenerative diseases, tumors, deformity, infection and trauma.

Dr. Tessitore has published over 80 papers and has given more than 120 lectures at different national and international meetings on topics relevant to spine diseases.

He is Member of the Educational Committee (EduCom) of the Eurospine society. He affiliated at the following societies: Eurospine, EANS, EANS spine section, AO Spine, Italian Neurosurgical Society (SINCH), SINCH Spine Section, Swiss Neurosurgical Society, Swiss Spine Society, and he is also advisory board member of the Journal of Neurosurgical Sciences and European Spine Journal. His main clinical research areas are the Cranio-vertebral junction surgery, Minimally invasive spine surgery, Robotic spine surgery, Thoracoscopic spine surgery, Spine deformity and spinal tumor surgery.

Amir R. Dehdashti, MD, FACS, FMH is the Director of Cerebrovascular Neurosurgery Research at North Shore University Hospital and Associate Professor of Neurosurgery at Hofstra Northwell School of Medicine in New York. Dr. Dehdashti completed his neurosurgery training under Professor de Tribolet in Geneva, Switzerland, and is board certified in neurosurgery by both the Swiss Board and the Board of the European Association of Neurosurgical Societies. Dr. Dehdashti completed fellowship training in both cerebrovascular and skull base surgery, including endoscopic skull base surgery, at the Toronto Western Hospital. He is one of the few dually trained cerebrovascular and skull base surgeons in the country with two dedicated and separate fellowships. Dr. Dehdashti has significant clinical expertise in performing complex intracranial surgery including cerebral bypass procedure which is performed only by a handful of expert neurosurgeons in the country. Dr. Dehdashti has published over 100 papers and has given more than 200 lectures at different national and international meetings on topics relevant to cerebrovascular, skull base tumors, pituitary tumors and cranial nerve disorders including trigeminal neuralgia. He has been involved in several retrospective and prospective studies relating to cerebrovascular neurosurgery. Dr. Dehdashti's clinical expertises include cerebrovascular surgery (aneurysm, AVM, brainstem cavernous malformation, Moyamoya disease, cerebral revascularization), carotid endarterectomy, minimally invasive surgery for aneurysms (mini craniotomy), minimally invasive endoscopic skull base surgery (pituitary and skull base tumors), surgery for cranial nerve disorders (trigeminal neuralgia, hemifacial spasm, glossopharyngeal neuralgia), skull base surgery, craniovertebral junction pathologies and acoustic neuroma surgery. His basic science and laboratory research is focused on molecular biology of brain AVMs. He is actively involved in the executive committees of North American Skull Base Society and Cerebrovascular Section of the AANS.

Claudio Schonauer, MD PhD, is Consultant of the Neurosurgical Unit at the ASLNapoli2 in Naples Italy . Specialist in Neurosurgery since 2000 and PhD in Neurooncology since 2004. He spent different years around Europe in France  (Lyon and Paris) and Erlangen (Germany). In 2015 was Consultant Neurosurgeon at the University of Geneva Suisse.

He was Chairman for Neurosurgery of the Italian Society of Young Surgeons, is SINCH board member since 1998 and from 2010 as Faculty member. Is a Faculty member of AO spine International . His surgical intersts moves from brain to spine surgery with expertise in ventricular Neuroendoscopy , complex spine and ventricular microsurgery. He has performed about 2000 brain and spine operations as first surgeon. He is present as reviewer in the editorial board of 7 indexed/impacted journals. Author of 61 published papers and different book chapters in neurosurgical international books.

Claudius Thome, MD, is Professor and Chairman of the Department of Neurosurgery at the Medical University Innsbruck, Austria. He is member at of the following societies: American Association of Neurological Surgeons (AANS), AO Spine (Education Officer Europe), Austrian Society of Neurosurgery (OEGNC, President), Austrian Society of Surgery (OEGCH, President), Austrian Spine Society (OEGW, Past President), German Academy of Neurosurgery (GANS, Secretary), German Society of Neurosurgery (DGNC), German Spine Society (DWG), European Association of Neurosurgical Societies (EANS; Chair-Elect of the Training Committee) and Spine Society of Europe (SSE). The main areas of research are evidence-based and minimal-invasive as well as complex spine surgery incl. regenerative approaches, spinal instrumentation and navigation, cerebrovascular surgery including revascularization, subarachnoid haemorrhage/cerebral vasospasm and neurotrauma incl. neurointensive care and neuromonitoring plus minimal-invasive skull base surgery.