New Trends in Craniovertebral Junction Surgery - Experimental and Clinical Updates for a New State of Art

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.


Massimiliano Visocchi is Assistant and Associate Professor in the Neurosurgical Department of the Catholic University of Rome. He is member of many neurosurgical societies and he is also involved in the board of several societies. Prof. Visocchi is the President elect of the International Society of Reconstructive Neurosurgery. He focuses on general  neurosurgery and particularly in Complex Spine Neurosurgery, Central Nervous System Stimulation, Haemodynamic monitoring in neurosurgical fields and pain treatment; as well as Neurotraumatology. Prof. Visocchi has produced over 400 scientific publications (more than 200 extensive papers  and book chapters in national and international scientific journals, books, congress brochures and 200 abstracts in congress brochures) and has given invited lectures in national and international congresses and courses.