SURGICAL VIDEO Safeguarding the Anomalous Vertebral Artery While Dissecting, Drilling, and Instrumentation of C1-2 Joint for Congenital Atlantoaxial Dislocation: 2-Dimensional Operative Video Pravin Salunke, MCh, Sushanta K. Sahoo, MCh Watch now at https://academic.oup.com/ons/article-lookup/doi/10.1093/ons/opy101 Department of Neurosurgery, PGIMER, Chandigarh, India Correspondence: Pravin Salunke, MCh, PGIMER, Sector 12, Chandigarh, India 160012 E-mail: firstname.lastname@example.org The pathology in congenital atlantoaxial instability is consequences. Alternatively, occipital squama can be usually in C1-2 joints. Addressing the joints appears to fused to the cervical spine. However, this requires fusion be the most rationale approach. The joints are usually of multiple segments affecting the neck movements approached posteriorly, manipulated, and fused. Under- significantly. An anomalous vertebral artery can be standing the normal and abnormal anatomy is important. dissected, mobilized, and safeguarded while dissecting, Normally, the third segment of the vertebral artery manipulating, and fusing the C1-2 joint. In this operative courses lateral to the C1-2 joint. However, in about 20% video, authors have highlighted the technique to of the cases with complex congenital craniovertberal safeguard the anomalous vertebral artery during joint junction anomalies the artery crosses the joint poste- manipulation. riorly. The artery in such cases may be injured while Proper informed consent was obtained from the joint manipulation and instrumentation with disastrous patient. KEY WORDS: Congenital anomalies, Atlantoaxial dislocation, Vertebral artery, Anomalous course, C1-2 joints, Realignment Operative Neurosurgery 0:1, 2018 DOI:10.1093/ons/opy101 Received, January 3, 2018. Accepted, April 4, 2018. Disclosure The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article. OPERATIVE NEUROSURGERY VOLUME 0 | NUMBER 0 | 2018 | 1 Downloaded from https://academic.oup.com/ons/advance-article-abstract/doi/10.1093/ons/opy101/4986871 by Ed 'DeepDyve' Gillespie user on 08 June 2018
Operative Neurosurgery – Oxford University Press
Published: Apr 26, 2018
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