The cranio-vertebral junction (CVJ) is present between the base of the skull and the upper region of the cervical spine. Any deviations or deformities in this region are known as cranio-vertebral junction anomalies. They can occur as congenital anomalies, developmental or secondary to other disease processes. Cranio-vertebral anomalies are classified into different types based on their causative factors.
There are various factors associated with CVJ anomalies. Some of them include:
The signs and symptoms of CVJ anomalies vary based on the cause, severity and specific structures affected. However, some common signs and symptoms may include:
Symptoms associated with spinal cord compression in the CVJ may include:
Symptoms associated with brain stem dysfunction may include:
Symptoms associated with lower cranial nerve dysfunction may include:
CVJ anomalies are diagnosed based on medical history, physical examination and diagnostic imaging scans. Lateral view X-rays, CT scan and MRI are used to visualise the structural abnormalities in the CVJ. CT scan is the most common diagnostic tool used for CVJ anomalies. However, if further investigations are required, MRI and CT myelography are considered.
Surgery is the treatment of choice for CVJ anomalies. The type of surgery and approach is decided based on some factors which include: traumatic causes, non-traumatic causes, reducible or irreducible lesions. Considering these factors, the basic surgical procedures involved are reduction, immobilization, decompression and fixation. Treatment may include any one of the procedures or a combination which is determined based on the nature, severity and risk factors of the disease.