Extended Endoscopic Endonasal Approach with or without C1–C2 Anterior Endoscopic Screw Fixation for Cranio-Vertebral Junction Lesions: Lesson Learned and Technical Nuances

Background Extended endoscopic endonasal approaches (EEA) are increasingly being used to address different types of anterior cranio-vertebral junction (aCVJ) diseases, including rheumatoid arthritis-related bulbo-medullary compression, basilar invagination in complex CVJ malformations and non-healed odontoid type II fractures. EEA, eventually supplemented by a variety of anterior endoscopic C1–C2 screw fixation and how these new techniques may help in extending indications or in implementing the conventional techniques, by combined approaches, in aCVJ lesions which require surgical treatment are illustrated and discussed.