Surgical management of tumors of the cervical spine and craniovertebral junction involving the vertebral artery: A narrative review.

Cervical spine Craniovertebral junction Encasement Tumor Vertebral artery

Journal

Neuro-Chirurgie
ISSN: 1773-0619
Titre abrégé: Neurochirurgie
Pays: France
ID NLM: 0401057

Informations de publication

Date de publication:
28 Mar 2024
Historique:
received: 28 02 2024
accepted: 12 03 2024
medline: 30 3 2024
pubmed: 30 3 2024
entrez: 29 3 2024
Statut: aheadofprint

Résumé

The vertebral artery (VA) is in close proximity to bony structures, nerves and nerve sheaths of the cervical spine and craniovertebral junction (CVJ). These structures can be sources of tumors that are responsible for displacement, encasement and sometimes invasion of the VA. Removing these tumors while minimizing the risk of vascular injury requires thorough knowledge of the vascular anatomy, risk factors of vascular injury, the relationships of each tumor type with the VA, and the different surgical approaches and techniques that result in the best outcomes in terms of vascular control, tumoral exposure and resection. To present an overview of preoperative and anatomical considerations, differential diagnoses and various approaches to consider in cases of tumors in close relationship with the VA. A review of recent literature was conducted to examine the anatomy of the VA, the tumors most frequently affecting it, surgical approaches, and the necessary pre-operative preparations for ensuring safe and maximal tumor resection. This review aims to underscore the principles of treatment. Tumors located at the CVJ and the cervical spine intimately involved with the VA, pose a surgical challenge and increase the risk of incomplete removal of the lesion. Detailed knowledge of the patient-specific anatomy and a targeted pre-operative work-up enable optimal planning of surgical approach and management of the VA, thereby reducing surgical risks and improving extent of resection.

Sections du résumé

BACKGROUND BACKGROUND
The vertebral artery (VA) is in close proximity to bony structures, nerves and nerve sheaths of the cervical spine and craniovertebral junction (CVJ). These structures can be sources of tumors that are responsible for displacement, encasement and sometimes invasion of the VA. Removing these tumors while minimizing the risk of vascular injury requires thorough knowledge of the vascular anatomy, risk factors of vascular injury, the relationships of each tumor type with the VA, and the different surgical approaches and techniques that result in the best outcomes in terms of vascular control, tumoral exposure and resection.
OBJECTIVE OBJECTIVE
To present an overview of preoperative and anatomical considerations, differential diagnoses and various approaches to consider in cases of tumors in close relationship with the VA.
METHOD METHODS
A review of recent literature was conducted to examine the anatomy of the VA, the tumors most frequently affecting it, surgical approaches, and the necessary pre-operative preparations for ensuring safe and maximal tumor resection. This review aims to underscore the principles of treatment.
CONCLUSION CONCLUSIONS
Tumors located at the CVJ and the cervical spine intimately involved with the VA, pose a surgical challenge and increase the risk of incomplete removal of the lesion. Detailed knowledge of the patient-specific anatomy and a targeted pre-operative work-up enable optimal planning of surgical approach and management of the VA, thereby reducing surgical risks and improving extent of resection.

Identifiants

pubmed: 38552591
pii: S0028-3770(24)00021-3
doi: 10.1016/j.neuchi.2024.101550
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

101550

Informations de copyright

Copyright © 2024 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.

Auteurs

Jean-Baptiste Peeters (JB)

Division of Neurosurgery, Department of Surgery, Centre Hospitalier de l'Universite de Montreal (CHUM), 1000 rue St-Denis, Montréal H2X 0C1, QC, Canada.

Leonardo Dessesard Olijnyk (L)

Division of Neurosurgery, Department of Surgery, Centre Hospitalier de l'Universite de Montreal (CHUM), 1000 rue St-Denis, Montréal H2X 0C1, QC, Canada.

Felix Janelle (F)

Division of Neurosurgery, Department of Surgery, Centre Hospitalier de l'Universite de Montreal (CHUM), 1000 rue St-Denis, Montréal H2X 0C1, QC, Canada.

Daniel Shedid (D)

Division of Neurosurgery, Department of Surgery, Centre Hospitalier de l'Universite de Montreal (CHUM), 1000 rue St-Denis, Montréal H2X 0C1, QC, Canada.

Michel W Bojanowski (MW)

Division of Neurosurgery, Department of Surgery, Centre Hospitalier de l'Universite de Montreal (CHUM), 1000 rue St-Denis, Montréal H2X 0C1, QC, Canada.

Moujahed Labidi (M)

Division of Neurosurgery, Department of Surgery, Centre Hospitalier de l'Universite de Montreal (CHUM), 1000 rue St-Denis, Montréal H2X 0C1, QC, Canada. Electronic address: moujahed.labidi@umontreal.ca.

Classifications MeSH