Chiari & Craniovertebral Junction
Our chiari and craniovertebral junction experts offer world-leading care through Feinberg-affiliated hospitals for patients suffering from disorders affecting this region. They utilize cutting-edge technologies to manage many of the diseases that affect the craniovertebral junction with excellent outcomes and minimal morbidity in a predictable fashion.
Education
The Department of Neurological Surgery hosts multiple academic events related to chiari and craniovertebral junction topics every year. Through our affiliated hospitals and care sites, residents and fellows can work with faculty on cases of congenital disorders, treatment of inflammatory conditions, surgical intervention of trauma and operative management of tumors.
Research
Some of our current clinical trials and technological development work include:
- Comparative effectiveness of contoured rods versus hinged rods in occipitocervical fusion
- A novel and simple technique to diagnose occipitocervical dissociation
- An algorithm for the management of patients with atlas assimilation
- Outcome of upper cervical spine surgery in patients with rheumatoid arthritis
- Use of intraoperative neuromuscular blockade in the reduction of chronic rotatory atlantoaxial subluxation
Patient Care
The craniovertebral junction or the upper cervical spine is defined as the region encompassing the occiput, the first and second cervical vertebra. This region represents a transitional area between the brain and the spine. Due to its unique structure and function many of the diseases affecting this area are challenging.
The disorders that affect this area can be encountered in infancy, childhood, adolescence and adulthood. These can be congenital, neoplastic (tumors), inflammatory, traumatic and degenerative.
Through the Feinberg-affiliated care site, department faculty treat the following types of disorders:
Congenital
- Chiari malformation
- Basilar invagination
- Atlas assimilation
- Os Odontoideum
Inflammatory
- Rheumatoid arthritis
- Ankylosing spondylitis
Traumatic
- Occipitocervical dissociation
- Atlantoaxial rotatory subluxation
- Atlas or C1 fractures/ Jefferson fractures
- Axis or C2 fractures: dens fractures, Hangmans fractures
- Combined C1 and C2 fractures
Neoplastic (tumors)
- Meningioma
- Nerve sheath tumors
- Chordoma
- Metastatic disease