[Occipitocervical fixation in the surgical treatment of pathologies of the craniovertebral junction].
OBJECTIVE
New surgical approaches to the tumors of the skull base necessitate removal of certain bone structures of the base. In the case of the transcondylar far-lateral approach, the whole occipital condyle and lateral mass of C1 are removed resulting in iatrogenic instability. Consequently, an occipitocervical fixation is needed. The aim of the study was to assess the usefulness of the CCD cervical system for the occipitocervical fixation in the surgery of the tumors of the craniovertebral junction.


METHODS
The authors present the application of the CCD cervical system produced by Medtronic Sofamor-Danek in three patients who underwent surgery of tumors of the foramen magnum, clivus or craniovertebral junction. The system consists of two titanium rods, which adjusted to the curvature of the spine and the occiput, are fixed by laminar cervical and occipital hooks, fixed to the trepanation hole edge or the edge of the foramen magnum. It is also possible to use screws driven to the occipital bone if it is more than 7 mm thick.


RESULTS
The system fixation is simple and relatively short. Good stabilization was achieved in all patients. No complications caused by the implants have been observed.


CONCLUSIONS
The CCD cervical system can be successfully used for the occipitocervical fixation in a lateral transcondylar approach and in the cases of other non-traumatic craniocervical instability. It is especially recommended in cases of unusual thinning of the occipital bone or in osteoporotic states.
Maliszewski
Mariusz
M
Katedra i Oddział Kliniczny Neurochirurgii w Sosnowcu. maliszewski_m@poczta.onet.pl
Ladziński
Piotr
P
Majchrzak
Henryk
H
D000328:Adult; D001863:Bone Screws; D002574:Cervical Vertebrae / Q000473:pathology / Q000601:surgery*; D003388:Cranial Fossa, Posterior / Q000601:surgery; D005260:Female; D005539:Foramen Magnum / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009777:Occipital Bone / Q000601:surgery*; D009778:Occipital Lobe / Q000601:surgery; D019292:Skull Base Neoplasms / Q000473:pathology / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*