{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T13:28:16Z","timestamp":1767706096398},"reference-count":10,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>Craniovertebral junction (CVJ) pathologies include atlantoaxial instability\/deformities resulting in myelopathy, respiratory failure, and even death. Here, we describe the indications, preoperative planning, and intra-operative\/postoperative complications following surgical management of CVJ anomalies.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Methods: <\/jats:title>\n<jats:p>A prospective analysis of 34 patients with CVJ pathology was evaluated between 2015 and 2022. Their various etiologies included atlantoaxial instability, trauma, tuberculosis, Down\u2019s syndrome, Morquio syndrome, os odontoideum, and atlantoaxial abnormalities. Clinical outcomes were assessed using the American spinal injury association (ASIA) impairment scale score and Benzel\u2019s modified Japanese Orthopedic Association (mJOA) score. Surgical assessments included length of hospital stay, operative time, blood loss, and intraoperative postoperative complications. Radiological parameters included fusion (i.e., implant loosening\/implant failure), preoperative\/ postoperative atlanto-dens interval (ADI), clivus canal angle (CCA), and space available for cord (SAC).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Results: <\/jats:title>\n<jats:p>Five patients were managed conservatively, while 29 patients had surgery. Operations included occipitocervical fusion (14 patients), C1\u20132 fusion (10 patients), C1\u20132 transarticular screw fixation (four patients), and one patient underwent anterior corpectomy decompression\/fusion. Seven patients had vertebral artery anomalies, and 13 patients had atlantoaxial abnormalities. At the final follow-up, atlantoaxial instability (i.e., mean preoperative ADI of 6.6 \u00b1 2.3 mm) was restored to 4.2 \u00b1 0.6 mm, significant cord compression (i.e., with mean SAC of 8.3 \u00b1 2.9 mm) was relieved to 17.2 \u00b1 1.6 mm, and the mean preoperative CCA (i.e., 130.2 \u00b1 15.3) was improved to 143.3 \u00b1 8.3\u00b0. There was also a statistically significant improvement in the ASIA scale and mJOA score.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st4\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>Surgical management of CVJ abnormalities requires expertise and meticulous planning to avoid devastating complications such as wound dehiscence and catastrophic vertebral artery injury.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_790_2023","type":"journal-article","created":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T08:12:59Z","timestamp":1699603979000},"page":"393","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Functional and radiological outcomes following craniovertebral junction surgery"],"prefix":"10.25259","volume":"14","author":[{"given":"Tushar N.","family":"Rathod","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sachin Mohana","family":"Khemkar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tapas","family":"Mohanty","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arjit","family":"Vashishtha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arun","family":"Kale","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akshay","family":"Phupate","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2023,11,10]]},"reference":[{"key":"10.25259\/SNI_790_2023\/ref-1","doi-asserted-by":"crossref","first-page":"1282","DOI":"10.2106\/00004623-199309000-00004","article-title":"Rheumatoid arthritis of the cervical spine. 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The effects of occipitocervical fusion","volume":"73","author":"Stevens","year":"1991","journal-title":"J Bone Joint Surg Br"},{"key":"10.25259\/SNI_790_2023\/ref-9","doi-asserted-by":"crossref","first-page":"1233","DOI":"10.1097\/00007632-199506000-00004","article-title":"Transoral anterior decompression and fusion of chronic irreducible atlantoaxial dislocation with spinal cord compression","volume":"20","author":"Subin","year":"1995","journal-title":"Spine (Phila Pa 1976)"},{"key":"10.25259\/SNI_790_2023\/ref-10","doi-asserted-by":"crossref","first-page":"E1348","DOI":"10.1097\/BRS.0b013e3182a1e5e4","article-title":"Novel surgical classification and treatment strategy for atlantoaxial dislocations","volume":"38","author":"Wang","year":"2013","journal-title":"Spine (Phila Pa 1976)"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/functional-and-radiological-outcomes-following-craniovertebral-junction-surgery\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/functional-and-radiological-outcomes-following-craniovertebral-junction-surgery\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T08:13:03Z","timestamp":1699603983000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/functional-and-radiological-outcomes-following-craniovertebral-junction-surgery\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,10]]},"references-count":10,"alternative-id":["10.25259\/SNI_790_2023"],"URL":"https:\/\/doi.org\/10.25259\/sni_790_2023","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"value":"2152-7806","type":"electronic"},{"value":"2229-5097","type":"print"}],"subject":[],"published":{"date-parts":[[2023,11,10]]},"article-number":"393"}}