Immersive Surgical Anatomy of the Craniocervical Junction

Vera Vigo; Ankit Hirpara; Mohamed Yassin; Minghao Wang; Dean Chou; Pasquale De Bonis; Adib Abla; Roberto Rodriguez Rubio

doi:10.7759/cureus.10364

Immersive Surgical Anatomy of the Craniocervical Junction

Cureus. 2020 Sep 10;12(9):e10364. doi: 10.7759/cureus.10364.

Authors

Vera Vigo¹, Ankit Hirpara¹, Mohamed Yassin¹, Minghao Wang², Dean Chou³, Pasquale De Bonis⁴, Adib Abla¹, Roberto Rodriguez Rubio¹

Affiliations

¹ Neurological Surgery, University of California San Francisco, San Francisco, USA.
² Neurological Surgery, First Affiliated Hospital of China Medical University, Shenyang, CHN.
³ Neurological Surgery, University of Caifornia San Francisco, San Francisco, USA.
⁴ Neurological Surgery, Ferrara University Hospital, Ferrara, ITA.

Abstract

With the advent and increased usage of posterior, lateral, and anterior surgical approaches to the craniocervical junction (CCJ), it is essential to have a sound understanding of the osseous, ligamentous, and neurovascular layers of this region as well as their three-dimensional (3D) orientations and functional kinematics. Advances in 3D technology can be leveraged to develop a more nuanced and comprehensive understanding of the CCJ, classically depicted via dissections and sketches. As such, this study aims to illustrate - with the use of 3D technologies - the major anatomical landmarks of the CCJ in an innovative and informative way. Photogrammetry, structured light scanning, and 3D reconstruction of medical images were used to generate these high-resolution volumetric models. A clear knowledge of the critical anatomical structures and morphometrics of the CCJ is crucial for the diagnosis, classification, and treatment of pathologies in this transitional region.

Keywords: atlas; axis; biomechanics; craniocervical junction; cruciform ligament; neuroanatomy; occipital bone; surgical lines; volumetric model.