Stabilization of the Craniocervical Junction Following Resection of Chordomas and Chondrosarcomas of the Skull Base and Spine

Abstract Until the last decade of the 20th century, craniocervical junction (CCJ) stabilization was achieved largely through simple instrumentation such as spinous process and lateral mass wiring. The introduction of rigid fixation anchors, including lateral mass and pedicle screws and improved occipital fixation, ushered in marked improvements for stabilization following resection of CCJ lesions, such as chordomas and chondrosarcomas. Tumor characteristics and the extent of resection impact CCJ stability and call for careful preoperative decision making. This chapter details our surgical technique for CCJ stabilization and summarizes the literature investigating this area.