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21 – Case-Based Anatomy of Traumatic Injury to the Craniocervical Junction 2013

Category General Spine Andrew Nicholson, MD
Arun Krishnan, MD
Purpose 1. To review the anatomy and intricate relationships of the craniocervical junction (CCJ) bones, ligaments, and muscles.  2. To detail some of the common traumatic injuries of the CCJ, and their radiographic appearance. 3. To briefly describe the clinical implications of these injuries. Materials & Methods 1. Anatomy of the CCJ with an emphasis on the detailed 3D relationships of the bones, muscles, and ligaments will be demonstrated via illustrations and cadaveric dissection pictures, with CT and MRI correlation. 2. Case-based examples of the most commonly encountered traumatic CCJ injuries. 3. Review of the clinical findings and treatments of these injuries. 4. An interactive quiz at the end to test the participant’s learning. Results Cases of craniocervical junction trauma are presented in a systematic format to demonstrate the anatomy and radiographic appearance of normal and abnormal structures.  CT is used to show the bony relationships of the occiput, C1, and C2, as well as fractures of these structures.  MRI cases illustrate the detailed ligamentous relationships of the CCJ, as well as the various appearances of injuries to the muscles and ligaments associated with these structures. Conclusion Detailed understanding of the anatomy and radiographic appearance of the normal craniocervical junction is necessary to provide accurate and clinically-relevant diagnoses of cervical spine trauma cases.  In this presentation we will provide simplified diagrams which will help explain the intricate milieu of the craniocervical junction, along with examples of how these relationships can be disrupted in the setting of trauma.  Additionally, we will review the basic clinical implications of these injuries to help define which are considered stable and which are considered unstable.  A quiz at the end of the presentation will help summarize key points, and test the participant's knowledge. References None