Perioperative Management of Craniocervical Junction Tumors

Objective: To analyze the clinical characteristics of patients with craniocervical junction space-occupying lesions and summarize the perioperative management experience in combined skull base and spinal neurosurgery. Methods: Medical records of patients who underwent combined skull base and spinal neurosurgery at Beijing Tiantan Hospital, Capital Medical University, from April 1, 2020, to April 1, 2025, were retrospectively analyzed. Clinical data, multidisciplinary treatment, anesthetic management, and outcomes were evaluated. Results: Among the 9 patients, 7 (77.8%) completed skull base tumor resection combined with cervical or atlanto occipital fusion internal fixation under one anesthesia. Two (22.2%) patients initially underwent only skull base tumor resection, but due to detected cervical instability during ICU stay, a second surgery for occipitocervical fusion was performed. Five (55.6%) patients were discharged with good recovery, one (11.1%) was discharged wearing a cervical orthosis, one (11.1%) with preoperative quadriplegia was discharged with residual deficits, one (11.1%) declined tumor resection and was discharged, and one (11.1%) died. Conclusion: Craniocervical junction lesions are rare. Preoperative multidisciplinary consultation should focus on assessing craniocervical stability. Intraoperative neuroprotection and strict postoperative vital sign monitoring are essential to prevent complications.