PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of skullbasesurgInstructions for AuthorsSubscribe to Skull BaseAbout Skull BaseEditorial BoardThieme Medical PublishingSkull Base An Interdisciplinary Approach ...
 
Skull base surgery. 1995 January; 5(1): 9–19.
PMCID: PMC1661790

Anterolateral and Posterolateral Approaches to the Foramen Magnum

Technical Description and Experience from 97 Cases

Abstract

Over a 12-year period (1981-1993), 97 lesions located in the foramen magnum area were treated using either the posterolateral or the anterolateral approach. The former is a lateral extent of the midline posterior approach; the latter is the technique of exposure of the cervical vertebral artery applied at the C-1 to C-2 level. The choice between the two types of lateral approaches was made following three modes of localization: anteroposterior attachment, relation to the dura, and relation to the vertebral artery. Both techniques are described in detail, with special attention paid to the bone and dural openings, which vary according to the localization.

The treated lesions include 91 tumors, 4 craniocervical junction malformations, 1 synovial cyst, and 1 abcess. A complete resection was realized in 95% of the tumoral cases, with a very limited morbidity and mortality (3%).

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (2.9M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Bonkowski JA, Gibson RD, Snape L. Foramen magnum meningioma: transoral resection with a bone baffle to prevent CSF leakage. Case report. J Neurosurg. 1990 Mar;72(3):493–496. [PubMed]
  • Bonney G, Williams JP. Trans-oral approach to the upper cervical spine. A report of 16 cases. J Bone Joint Surg Br. 1985 Nov;67(5):691–698. [PubMed]
  • Crockard HA. Anterior approaches to lesions of the upper cervical spine. Clin Neurosurg. 1988;34:389–416. [PubMed]
  • Crockard HA, Sen CN. The transoral approach for the management of intradural lesions at the craniovertebral junction: review of 7 cases. Neurosurgery. 1991 Jan;28(1):88–98. [PubMed]
  • Delandsheer JM, Caron JP, Jomin M. Voie trans-bucco-pharyngée et malformations de la charnière cervico-occipitale. Neurochirurgie. 1977 Oct 20;23(4):276–281. [PubMed]
  • Derome P, Caron JP, Hurth M. Indications de la voie trans-bucco-pharyngée et malformations de la charnière cranio-vertébrale. Neurochirurgie. 1977 Oct 20;23(4):282–285. [PubMed]
  • Greenberg AD, Scoville WB, Davey LM. Transoral decompression of atlanto-axial dislocation due to odontoid hypoplasia. Report of two cases. J Neurosurg. 1968 Mar;28(3):266–269. [PubMed]
  • Hadley MN, Spetzler RF, Sonntag VK. The transoral approach to the superior cervical spine. A review of 53 cases of extradural cervicomedullary compression. J Neurosurg. 1989 Jul;71(1):16–23. [PubMed]
  • Lecuire J, Dechaume JP, Buffard P, Bochu M. Les méningiomes de la fosse cérébrale postérieure. Neurochirurgie. 1971 May;17:1–146. [PubMed]
  • Louis R. Chirurgie atloïdo-axoïdienne par voie transorale. Rev Chir Orthop Reparatrice Appar Mot. 1983;69(5):381–391. [PubMed]
  • Pásztor E, Vajda J, Piffkó P, Horváth M, Gádor I. Transoral surgery for craniocervical space-occupying processes. J Neurosurg. 1984 Feb;60(2):276–281. [PubMed]
  • de Rougemont J, Abada M, Barge M. Les possibilités de la voie d'abord antérieure dans les lésions des trois premières vertèbres cervicales. Neurochirurgie. 1966 May-Jun;12(3):323–336. [PubMed]
  • Salcman M, Jamaris J, Leveque H, Ducker TB. Transoral cervical corpectomy with the aid of the microscope. Spine (Phila Pa 1976) 1979 May-Jun;4(3):209–212. [PubMed]
  • SOUTHWICK WO, ROBINSON RA. Surgical approaches to the vertebral bodies in the cervical and lumbar regions. J Bone Joint Surg Am. 1957 Jun;39-A(3):631–644. [PubMed]
  • CASTELLANO F, RUGGIERO G. Meningiomas of the posterior fossa. Acta Radiol Suppl. 1953;104:1–177. [PubMed]
  • Bertalanffy H, Seeger W. The dorsolateral, suboccipital, transcondylar approach to the lower clivus and anterior portion of the craniocervical junction. Neurosurgery. 1991 Dec;29(6):815–821. [PubMed]
  • George B, Dematons C, Cophignon J. Lateral approach to the anterior portion of the foramen magnum. Application to surgical removal of 14 benign tumors: technical note. Surg Neurol. 1988 Jun;29(6):484–490. [PubMed]
  • George B, Lot G, Velut S, Gelbert F, Mourier KL. Société de neurochirurgie de langue française. 44e congrès annuel. Bruxelles, 8-12 juin 1993. Pathologie tumorale du foramen magnum. Neurochirurgie. 1993;39 (Suppl 1):1–89. [PubMed]
  • Sen CN, Sekhar LN. An extreme lateral approach to intradural lesions of the cervical spine and foramen magnum. Neurosurgery. 1990 Aug;27(2):197–204. [PubMed]
  • George B, Laurian C, Keravel Y, Cophignon J. Extradural and hourglass cervical neurinomas: the vertebral artery problem. Neurosurgery. 1985 May;16(5):591–594. [PubMed]
  • Ryken TC, Menezes AH. Cervicomedullary compression by separate atlantal lateral mass. Pediatr Neurosurg. 1993 May-Jun;19(3):165–168. [PubMed]
  • Sen CN, Sekhar LN. Surgical management of anteriorly placed lesions at the craniocervical junction--an alternative approach. Acta Neurochir (Wien) 1991;108(1-2):70–77. [PubMed]

Articles from Skull Base Surgery are provided here courtesy of Thieme Medical Publishers