ArticleActa neurochirurgica. Supplement2023
Combined Transoral Exoscope and OARM-Assisted Approach for Craniovertebral Junction Surgery. New Trends in an Old-Fashioned Approach.
Article in Acta neurochirurgica. Supplement, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- O-arm-assisted endoscopic endonasal decompression for medullary compression caused by a clival osteophyte: illustrative case.Journal of neurosurgery. Case lessons · 2026Article
- Anterior Petrosectomy vs. Retrosigmoid Approach-Surgical Anatomy and Navigation-Augmented Morphometric Analysis: A Comparative Study in Cadaveric Laboratory Setting.Brain sciences · 2025Article
- Handling Editor: Prof F KandzioraNew frontiers in craniovertebral junction surgery: How innovations are changing the game.Brain & spine · 2025Article
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Abstract
backgroundThe introduction of recent innovations in the field of intraoperative imaging and neuronavigation, such as the O-arm StealthStation, allows for obtaining crucial intraoperative data by performing safer and controlled surgical procedures. As part of the improvement of surgical visual magnification and wide expansion of surgical corridors, the 3D 4 K exoscope (EX) has nowadays become an interesting and useful tool. The transoral approach (TOA) is the historical gold-standard direct microsurgical route to ventral craniovertebral junction (CVJ).
methodsWe herein report our experience, consisting of ten cases via TOA concerning the simultaneous application of an O-arm with a StealthStation navigation system (Medtronic, Memphis, TN) and an imaging system, along with the 3D 4 K exoscopes in the TOA, for the treatment of CVJ pathologies.
resultsNo intraoperative neurophysiological changes or postoperative infections occurred, but neurological improvement was evident in all the patients. A complete decompression and a stable instrumentation and fusion of the CVJ were accomplished in all cases at the maximum follow-up time.
conclusionsWith EX, the role of the surgeon becomes self-sufficient with better individual surgical freedom compared to endoscopic surgery and excellent 3D vision and magnification. O-arms offer absolutely reliable intraoperative support for more-effective CVJ decompression. Nevertheless, with O-arm-assisted neuronavigation, it can be difficult to navigate C1 lateral masses and C2 isthmi, and converting 3D into 2D real-time navigation can be quite complicated. Finally, the combination of an EX with an O-arm appears more time-consuming compared to the old-fashion one.
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