{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T10:31:01Z","timestamp":1767349861294,"version":"3.48.0"},"reference-count":10,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n The craniovertebral junction (CVJ) is surgically challenging due to its complex anatomy and proximity to vital neurovascular structures. This study aims to evaluate the use of 3D multiplanar reconstruction technique and its impact on surgical and radiological outcomes.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Thirty patients with CVJ anomalies operated on between July 2022 and December 2024 were included. Of the thirty patients, 15 had basilar invagination, six had atlanto-axial dislocation, five had C2 fractures with instability, and four had Arnold\u2013Chiari malformations with instability. Preoperative 3D-computed tomography (CT) and CT angiography reconstructions were performed to evaluate vertebral artery (VA) anatomy, C2 pedicle, C1 lateral mass, C1\u2013C2 facet joint inclination, pseudo-joints, and craniocervical tilt. All patients underwent C1\u2013 C2 fixation or occipito-cervical fixation with joint manipulation using spacers. Pre and postoperative neurological recovery were assessed using Nurick and modified Japanese Orthopedic Association grading. Postoperative CT was done in all cases.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Twenty-six underwent C1\u2013C2 fixation and four patients underwent occipito-cervical fixation. No VA injuries or screw-related complications occurred. One patient required revision due to implant failure. Neurological improvement occurred in 90% of cases. Radiological indices (Chamberlain line, McRae line, atlanto-dental interval, clivus canal angle) showed significant postoperative improvement.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Preoperative 3D multiplanar CT reconstruction enables detailed analysis of CVJ anatomy and VA variations, improving safety and surgical outcomes in complex anomalies.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_1095_2025","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T12:10:10Z","timestamp":1766146210000},"page":"536","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Preoperative 3D-CT-based planning for complex craniovertebral junction anomalies: Technique and surgical outcome"],"prefix":"10.25259","volume":"16","author":[{"given":"Vikrant","family":"Keshri","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, SBKS Medical Institute and Research Center, Vadodara, Gujarat, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Supriya","family":"Keshri","sequence":"additional","affiliation":[{"name":"Department of General Surgery, SBKS Medical Institute and Research Center, Vadodara, Gujarat, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2025,12,19]]},"reference":[{"key":"10.25259\/SNI_1095_2025\/ref-1","first-page":"2666","article-title":"The technique of using three-dimensional and multiplanar imaging for preoperative planning in pediatric CVJ anomalies","volume":"25","author":"Chaudhary","year":"2021","journal-title":"NASS Open Access"},{"key":"10.25259\/SNI_1095_2025\/ref-2","doi-asserted-by":"crossref","first-page":"1760","DOI":"10.1097\/00007632-200007150-00004","article-title":"Accuracy of atlantoaxial transarticular screw insertion","volume":"25","author":"Fuji","year":"2000","journal-title":"Spine (Phila Pa 1976)"},{"key":"10.25259\/SNI_1095_2025\/ref-3","doi-asserted-by":"crossref","first-page":"155","DOI":"10.3171\/spi.2005.2.2.0155","article-title":"Atlantoaxial transarticular screw fixation: A review of surgical indications, fusion rate, complications, and lessons learned in 191 adult patients","volume":"2","author":"Gluf","year":"2005","journal-title":"J Neurosurg Spine"},{"key":"10.25259\/SNI_1095_2025\/ref-4","doi-asserted-by":"crossref","first-page":"186","DOI":"10.14245\/ns.1938138.069","article-title":"A review of a new clinical entity of \u2018central atlantoaxial instability\u2019: Expanding horizons of craniovertebral junction surgery","volume":"16","author":"Goel","year":"2019","journal-title":"Neurospine"},{"key":"10.25259\/SNI_1095_2025\/ref-5","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1097\/00006123-200212000-00004","article-title":"Atlantoaxial fixation using plate and screw method: A report of 160 treated patients","volume":"51","author":"Goel","year":"2002","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_1095_2025\/ref-6","first-page":"125","article-title":"Understanding the course of vertebral artery at craniovertebral junction in occipital assimilation of atlas: Made simplified using conventional angiography","volume":"8","author":"Jagetia","year":"2017","journal-title":"J Craniovertebr Junction Spine"},{"key":"10.25259\/SNI_1095_2025\/ref-7","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1148\/rg.240075","article-title":"Imaging of craniovertebral junction instability, fixation, and fusion: A radiologic perspective","volume":"45","author":"Little","year":"2025","journal-title":"Radiographics"},{"key":"10.25259\/SNI_1095_2025\/ref-8","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1097\/01.BRS.0000051919.14927.57","article-title":"Atlantoaxial transarticular screw fixation for a high-riding vertebral artery","volume":"28","author":"Neo","year":"2003","journal-title":"Spine (Phila Pa 1976)"},{"key":"10.25259\/SNI_1095_2025\/ref-9","doi-asserted-by":"crossref","first-page":"109641","DOI":"10.1016\/j.mehy.2020.109641","article-title":"A possible novel technique for intraoperative imaging of the vertebral artery during arthrodesis of the upper cervical spine","volume":"140","author":"Pavlov","year":"2020","journal-title":"Med Hypotheses"},{"key":"10.25259\/SNI_1095_2025\/ref-10","first-page":"1","article-title":"C1-C2 joint distraction and fusion: A robust surgical approach for craniovertebral junction instability","volume":"10","author":"Shetty","year":"2024","journal-title":"J Neurosci"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/preoperative-3d-ct-based-planning-for-complex-craniovertebral-junction-anomalies-technique-and-surgical-outcome\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/preoperative-3d-ct-based-planning-for-complex-craniovertebral-junction-anomalies-technique-and-surgical-outcome\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T10:28:14Z","timestamp":1767349694000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/preoperative-3d-ct-based-planning-for-complex-craniovertebral-junction-anomalies-technique-and-surgical-outcome\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,19]]},"references-count":10,"alternative-id":["10.25259\/SNI_1095_2025"],"URL":"https:\/\/doi.org\/10.25259\/sni_1095_2025","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"type":"electronic","value":"2152-7806"},{"type":"print","value":"2229-5097"}],"subject":[],"published":{"date-parts":[[2025,12,19]]},"article-number":"536"}}