Craniocervical Junction Surgery
Craniocervical junction surgery is an operation performed on the bones in the junction between the skull and the spine. The craniocervical junction includes the bone that forms the base of the skull, called the occipital bone, and the first two bones in the spine, called the atlas and the axis.
Craniocervical junction surgery may be used to treat disorders or deformities of the upper neck that are present at birth or occur later in life.
Disorders that affect the large opening at the bottom of the occipital bone (called the foramen magnum) are a particular concern because important structures pass through this opening. These structures include the lowest part of the brain (brain stem), which transitions into and is structurally continuous with the spinal cord, as well as certain nerves and blood vessels.
Craniocervical junction injuries are divided into two groups: injuries affecting mainly bone structures and injuries to the ligaments. Injuries to the ligaments cause instability between the spine and the skull and generally require surgery. Injuries to the bones of the craniocervical junction can sometimes be treated conservatively, with surgery reserved for injuries that cause instability.
Disorders that can affect the craniocervical junction later in life include:
- Rheumatoid arthritis
- Paget’s disease
- Tumors of the craniocervical junction
Disorders that can affect the craniocervical junction from birth can involve isolated or general disorders.
Isolated disorders include:
- Basilar invagination
- Atlas assimilation
- Atlantoaxial subluxation or dislocation
- Atlas hypoplasia
- Klippel-Feil malformation
- Chiari malformation
- Os odontoideum
General disorders may include the same abnormalities in the craniocervical junction as isolated disorders, but these are part of a larger group of abnormalities, such as:
- Down syndrome
- Osteogenesis imperfecta
You may be a candidate for surgery if you have had a traumatic injury to your craniocervical junction or if you have a disease that affects it. Not all disorders of the craniocervical junction require surgery to correct, and your neurosurgeon will be able to help you decide between surgery and more conservative measures.
Information and Resources
- Date of last review: May 24, 2017