Craniovertebral Junction, C1-2 (atlantoaxia lcomplex/junction), and Transoral Spinal Surgery

Image: Young male from China with ankylosing spondilitis and had rotated his head and locked in the position seen below from dislocation of the C1-2 vertebrae that required a complex reconstruction procedure to reposition his head to a normal position

The region where the head and neck articulate has unique and highly complex anatomy and function in a high-risk region that typically requires particular expertise in the treatment. The treatment largely depends upon a clear understanding of the biomechanics of this region, and the surgical treatment often requires precision surgical techniques in a region that is infrequently treated by neurosurgeons and orthopedic spine
surgeons. Dr Johnson has extensive experience having performed over 500 procedures that include transoral surgery, treating C1-2 degenerative and deformity cases, tumors, and fractures involving the odontoid and atlanto-axial complex.

Baron E, Siddique K, Perri B, Anand N, Johnson JP. “ Anterior Transoral Resection”; in Operative Techniques in Orthopaedics, (Eds. Freddie H. Fu, MD), Vol. 17(3) July 2007, pp.156-162.

Patel NP, Choi WW, Wright NM, McBride DQ, Johnson JP: Forestier’s disease associated with a retro-odontoid mass causing cervicomedullary compression. Journal of Neurosurgery (Spine 2) 96:188-194, 2002.

Image: Compression of the spinal cord at the craniovertebral junction

Stokes JK, Villavicencio AT, Liu PC, Bray RS, Johnson JP: Posterior atlantoaxial stabilization: a new alternative to C1-2 transarticular screws.  Neurosurgical Focus 12(1): Article 6, January 2002.

Patel NP, Choi WW, Wright NM, McBride DQ, Johnson JP: Forestier’s Disease Associated with a Retro-odontoid mass causing cervicomedullary compression.  Skull Base 11(Supplement 1): 2001.

Bloch O, Holly LT, Johnson JP: Accuracy of image guided placement of C1-2 transarticular screws. Journal of Neurosurgery:Spine 95:74-79, July 2001.

Yue J, Guyer D, Johnson JP, Khoo LT, Hochschuler ST: The Comprehensive Treatment of the Aging Spine Minimally Invasive and Advanced Techniques.  Elsevier Publishing Philadelphia , PA  2010.