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Rinchen Phuntsok, Benjamin J. Ellis, Michael R. Herron, Chase W. Provost, Andrew T. Dailey and Douglas L. Brockmeyer

responsible for OA (Oc–C1) and AA (C1–2) joint stability. In this study, we aim to shed light on this important subject by using the finite element (FE) method (FEM). Many previous studies have investigated the biomechanical contribution of various ligamentous structures on craniocervical junction (CCJ) stability. 31 , 35 , 36 , 38 Most of these studies have used cadaveric material, employing a process of sequential weakening or removal of stabilizing structures, to arrive at their conclusions. 5 , 7 Unfortunately, this paradigm creates an experimental condition in which

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Rinchen Phuntsok, Chase W. Provost, Andrew T. Dailey, Douglas L. Brockmeyer and Benjamin J. Ellis

T he craniocervical junction (CCJ) is a complex, highly mobile region of the cervical spine. Its motion is facilitated by the occipitoatlantal (OA) and the atlantoaxial (AA) joints, which are stabilized by several osteoligamentous structures. These structures include the transverse ligament (TL), tectorial membrane (TM), alar ligaments (ALs), OA capsular ligaments (OACLs), and AA capsular ligaments (AACLs). In a previous study using finite element (FE) modeling techniques, we found that the OACLs play a significant role stabilizing the OA joint (C0–C1). 17 In

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Gregory F. Jost and Andrew T. Dailey

patients presented with congenital anomalies such as a bony malformation at C1–2 or a suboccipital bony protuberance impinging on the VA. 6 , 22 In adults, the compressive cause depended on the location. At the craniocervical junction, the VA was fixed to an ossified or thickened atlanto-occipital membrane ( Fig. 5 ) 37 , 41 or compressed by a dural fold in the foramen magnum, 1 an assimilated posterior ring of C-1 with bilateral condylar and clival hypoplasia and platybasia, 34 an accessory ossicle behind the left atlanto-odontoid junction, 53 erosive rheumatoid

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Michael A. Finn, Daniel R. Fassett, Todd D. Mccall, Randy Clark, Andrew T. Dailey and Darrel S. Brodke

Each step along the course of evolution of these constructs has increased biomechanical stability, resulting in higher fusion rates and decreased reliance on rigid external orthoses, and has allowed for the fixation of fewer segments. 1 , 7 , 17 , 26 , 28 , 31 , 35 Recent clinical and biomechanical reports on the use of screw fixation of the craniocervical junction have examined either TASF or C1L-C2P or pedicle screw fixation as a means of securing the first 2 cervical vertebrae. 11 , 27 Although these methods have shown biomechanical equivalence in

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Vijay M. Ravindra, Kaine Onwuzulike, Robert S. Heller, Robert Quigley, John Smith, Andrew T. Dailey and Douglas L. Brockmeyer

thoracolumbar fusion cohort; this highlights the importance of long-term clinical follow-up and the need for radiographic surveillance over time, especially in patients with lower CXA. Global spinal alignment, specifically how cervical alignment is impacted by thoracolumbar regional alignment, has recently become a topic of interest in the adult deformity literature. 28 The pediatric craniocervical junction (CCJ) is a complex network of bony elements (occiput, atlas [C-1], axis [C-2]), ligamentous structures, and soft tissue and muscle development. 26 We postulate that the

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. Given our small cohort of patients treated without orthosis, it is possible that isolated OCF may be treated without cervical orthosis at all. Neurosurg Focus Neurosurgical Focus FOC 1092-0684 American Association of Neurological Surgeons 10.3171/2017.3.FOC-DSPNabstracts 2017.3.FOC-DSPNABSTRACTS Kline Peripheral Nerve Award Presentation 166. A Finite Element Analysis of the Occitipoatlantal Capsular Ligaments as the Primary Stabilizers of the Craniocervical Junction Andrew T. Dailey , MD , Rinchen Phuntsok