Anterior C1-2 Fixation
Procedure notes • Instability of C1-2 may be due to trauma, infection, tumors, or rheumatoid arthritis. In deciding the appropriate management of unstable C1-2 injuries, the patient’s age, medical status,…
Transarticular Screws for C1-2 Fixation
Indications • Indications for C1-2 transarticular screw fixation are atlantoaxial instability, rheumatoid arthritis, congenital abnormalities, os odontoideum, tumor, and ligamentous abnormality. Trauma and rheumatoid arthritis are the two most common…
Occipitocervical Fusion
Indications • Occipitocervical fusion is performed for craniovertebral junction (CVJ) instability resulting from various etiologies. • Posttraumatic: Atlantooccipital dislocation, complex fractures involving CVJ, unstable odontoid fractures with incompetence of the…
Insertion of Ventriculoperitoneal Shunt
Indications • Hydrocephalus, communicating or obstructive, which is not amenable to endoscopic third ventriculostomy or treatment of primary etiology (i.e., removal of fourth ventricle neoplasm) • Failure of previously placed…
C1-2 Posterior Cervical Fusion
Indications • C1-2 posterior cervical fusion is indicated in patients with odontoid fractures that cannot be repaired with an odontoid screw, including type II odontoid fractures associated with fractures of…
Craniosynostosis: Frontoorbital Advancement and Cranial Vault Reshaping (Open and Endoscopic)
Indications • The main indications for surgical intervention for craniosynostosis are the prevention of potential neurologic impairment and correction of deformity. Increased intracranial pressure, hydrocephalus, mental retardation, visual abnormalities, and…
Endoscopic Third Ventriculostomy
Indications • Patients with late-onset (adolescent or adult) nontumoral obstructive hydrocephalus have the highest rate of success after endoscopic third ventriculostomy (close to 90%). The high success rate in this…
Arachnoid Cyst Fenestration
Indications • Fenestration of arachnoid cysts is indicated in cysts that show significant increase in size or associated clinical symptoms. The size of an arachnoid cyst typically remains stable or…
Endoscopic Transsphenoidal Approach
Indications • Indications for the transsphenoidal approach have significantly increased with the addition of the endoscope. Using a team approach with a skilled endoscopic rhinologist has rendered the endoscopic transsphenoidal…
Encephalocele Repair
Indications • The presence of an encephalocele is an indication for surgical repair. Encephaloceles are typically diagnosed at birth, although many are now identified in utero by ultrasound. • Indications…
