Craniovertebral Junction Surgery

Craniovertebral junction surgery refers to corrective surgery on the bones where the skull and the spine intersect. The craniocervical junction comprises the occipital bone, which forms the skull’s base, along with the atlas and the axis, the first two vertebral bones. This surgical procedure aims to address craniocervical injuries, which can be categorized into two types: injuries that impact the bones and injuries that affect the ligaments.

Why is Craniocervical Junction Surgery Performed?

Craniocervical junction surgery is performed to correct malformations or deformities in the upper neck region. Due to the presence of important structures passing through the foramen magnum, a large opening at the base of the occipital bone, disorders affecting this area require special attention. These structures include various nerves, blood vessels, and the lower part of the brain stem, which seamlessly connects to the spinal cord. Craniocervical junction surgery is recommended for individuals with the following conditions:

• Infection
• Trauma
• Paget’s disease
• Atlas hypoplasia
• Down syndrome
• Achondroplasia
• Rheumatoid arthritis
• Hindbrain herniation
• Basilar invagination
• Tumors of the craniovertebral junction
• Malalignment of the craniovertebral junction
• Congenital anomalies of the craniovertebral junction

What are the Tests to be Done Before Craniocervical Junction Surgery?

Before the surgery, you will be required to undergo the following tests to understand and evaluate the severity of the condition –

• Lateral view X-ray
• Computerized Tomography (CT Scan)
• Magnetic Resonance Imaging (MRI)
• CT Myelography

How is Craniocervical Junction Surgery Done at Apollo Hospitals, Karnataka?

At Apollo Hospitals, our doctors take preventive care and measures to ensure the surgery is conducted at ease and without any complications –

Before the Procedure

Before the surgery, our doctors will discuss with you about the procedure and advise you on the do’s and don’ts during and after the surgery. Tell your doctor about your current medical conditions (if any). You will be asked to exercise regularly to ensure smooth surgery. You will also be advised on the following –

• Stop smoking
• Avoid alcohol consumption
• Stop taking blood thinners
• Eat healthy diet
• Exercise properly

Don’t hesitate to ask questions if you have any.

During the Procedure

The neurosurgeon typically performs corrective surgery based on the diagnosis report. After you have been admitted to the hospital, anaesthesia will be administered through an IV to ensure pain elimination during the procedure.

Depending on the specific area to be treated, various approaches may be utilized, such as the nose, mouth, chin, nape of the neck, or side of the neck. Consequently, the muscles are retracted to expose the targeted area for the operation. The surgeon then makes a small incision and proceeds to make the necessary corrections to stabilize the affected area using rods, plates, and screws. Once the area is stabilized, the muscles are repositioned, and the incision is carefully closed and dressed.

After the Procedure

After the procedure, it is common to experience pain and tingling sensations around the incision area. Typically, the pain diminishes within a few days, but if it becomes unbearable, pain medication can be provided. You will be required to remain at the hospital for monitoring purposes as there is a possibility of pain and complications arising within 12-24 hours following the surgery. At Apollo Hospitals, our doctors continue to provide care and attention even after the procedure. They will advise you to follow up to ensure proper neck mobility. In the initial days following the surgery, you will be instructed to consume clear liquid food.

Recovery

Once you return home, it will be necessary for you to rest for a minimum of 4-6 weeks. The doctors will provide guidance on activities to avoid and those that are permissible. Engaging in strenuous physical activities will be strictly prohibited. A physical therapist will be assigned to assist you in initiating movement, such as sitting up and moving around in bed. It is possible that you may be advised to use a cane or walker while walking for a few months. Additionally, you may experience soreness and tightening of the thigh and buttock muscles.

What are the Risks Associated with Craniovertebral Junction Surgery?

The following complications, although relatively infrequent, may occur:

• Screw loosening
• Fixation system
• Dural fistula
• Neural or vascular damage
• Wound infection
• Bleeding or hematoma
• Injury to the spinal cord or nerves
• C5 palsy, which causes paralysis in the arms
• Infection at the incision area

Are You a Good Candidate for Craniocervical Junction Surgery?

You might be a good candidate for craniocervical junction surgery if you have ever had a traumatic injury to your craniocervical junction or if you have an injury that causes severe complications. Not all craniocervical surgeries require surgery. However, this would be determined by the doctors to determine if you would need surgery or if more conservative measures are sufficient.

At Apollo Hospitals, Karnataka, the doctors consider all factors, such as age and type of injuries, to ensure a smooth operation. We strive to serve you better with world-class equipment. Additionally, we provide assistance to you after your operation.