This issue of Acta Neurochirururgica presents the latest surgical and experimental approaches
to the craniovertebral junction (CVJ). It discusses anterior midline (transoral transnasal)
posterior (CVJ craniectomy laminectomy laminotomy instrumentation and fusion) posterolateral
(far lateral) and anterolateral (extreme lateral) approaches using state-of-the-art supporting
tools. It especially highlights open surgery microsurgical techniques neuronavigation the
O-arm system intraoperative MR neuromonitoring and endoscopy. Endoscopy represents a useful
complement to the standard microsurgical approach to the anterior CVJ: it can be used
transnasally transorally and transcervically and it provides information for better
decompression without the need for soft palate splitting hard palate resection or extended
maxillotomy. While neuronavigation allows improved orientation in the surgical field
intraoperative fluoroscopy helps to recognize residual compression. Under normal anatomic
conditions there are virtually no surgical limitations to endoscopically assisted CVJ and this
issue provides valuable information for the new generation of surgeons involved in this complex
and challenging field of neurosurgery.
