Managing the Anomalous Vertebral Artery in C1–C2 Stabilization for Congenital Atlantoaxial Instability

Roopesh Kumar Vadivel Rathakrishnan; Sunil Kapilavayi Raghavendra

doi:10.1055/s-0040-1714404

Journal of Neurological Surgery Part B: Skull Base, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · J Neurol Surg B Skull Base 2021; 82(S 01): S63-S64
DOI: 10.1055/s-0040-1714404

Skull Base: Operative Videos

Managing the Anomalous Vertebral Artery in C1–C2 Stabilization for Congenital Atlantoaxial Instability

Roopesh Kumar Vadivel Rathakrishnan

¹Institute of Neurosciences, Sri Ramaswamy Memorial Institutes for Medical Sciences, Chennai, Tamil Nadu, India

,

Sunil Kapilavayi Raghavendra

¹Institute of Neurosciences, Sri Ramaswamy Memorial Institutes for Medical Sciences, Chennai, Tamil Nadu, India

› Institutsangaben

Abstract

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Keywords

anomalous vertebral artery - atlantoaxial stabilization - cranial assimilation

Fig. 1 (A) Sagittal CT scan - bone window shows Cranial Assimilation of Atlas. (B) T2 weighted sagittal image shows atlantoaxial dislocation with indentation of the cervicomedullary junction anteriorly and T2 hyperintense changes in the cord. (C) 3D CT angio shows anomalous position of the vertebral artery on the left side coursing more medially near the C2 pedicle. (D) Postoperative X-ray shows C1 lateral mass and C2 pedicle screws with spacers in the C1 C2 joint space.

Fig. 2 (A) Intraoperative image shows the vertebral artery being more medially located on the C2 lamina; (B) Intraoperative image shows the position of the screws and the vertebral artery free from the position of the screws.

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Fig. 1 (A) Sagittal CT scan - bone window shows Cranial Assimilation of Atlas. (B) T2 weighted sagittal image shows atlantoaxial dislocation with indentation of the cervicomedullary junction anteriorly and T2 hyperintense changes in the cord. (C) 3D CT angio shows anomalous position of the vertebral artery on the left side coursing more medially near the C2 pedicle. (D) Postoperative X-ray shows C1 lateral mass and C2 pedicle screws with spacers in the C1 C2 joint space.

Fig. 2 (A) Intraoperative image shows the vertebral artery being more medially located on the C2 lamina; (B) Intraoperative image shows the position of the screws and the vertebral artery free from the position of the screws.