joncţiunea cranio spinală
TRANSCRIPT
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Joncţiunea cranio-spinală-aborduri neurochirurgicale-
Cristina Aldea
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Înainte de a începe…
Câmp operator peste sau la nivelul Atriului Drept
Mobilitate masă Echipament anestezic
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Embolie aerică
Hemoragie intraoperatorie
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Cum putem aborda JCS ?
• Anterior: endonazal
transoral
transmandibular
transcervical
• Posterior: median
lateral
extrem Lateral
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Important:
• Fără sau Minimă intersecţie cu Nervi
• Prezervarea stabilităţii
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Abordul Posterior Median
• Tradiţional, “Simplu”• Decompresia Simplă a Structurilor Neurale (traumă,
MAC)
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Ligament nuchal
(monocauter)
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Artera Vertebrală!
Inserţii musculareImportante dpdv biomecanic
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Abordul Extrem Lateral
• Acces la : parte inferioară clivus
parte anterolaterala foramen magnum
joncţiune punte-bulb
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Abordul Endonazal
• Extradural!
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