Minimally Invasive Techniques Applied to the Cranio-Vertebral Junction

Unlike modern cervical and thoracolumbar surgery, many spine surgeons are not familiar with minimally invasive (MIS) techniques at the craniovertebral junction (CVJ). Due to its unique and complex anatomic structure, the CVJ is a technically challenging location for performing instrumentation and fusion. MIS approaches for anterior odontoid fixation, anterior transarticular fixation, posterior atlantoaxial fixation, and anterior occiput-to-axis fixation have been developed to fix fracture or instability due to a variety of pathologic conditions. With limited evidence in the literature, the application of MIS techniques to the CVJ awaits further effort from experts in spine surgery.