How I do it: lateral approach for craniocervical junction tumors

Abstract

Background: The far lateral approach has been developed to access lesions at the craniocervical junction and upper cervical spinal canal. Associated morbidity triggered the development of less invasive tailored approaches.

Method: In this lateral approach to the craniocervical junction, the occipital condyle is kept intact, vertebral artery manipulation is minimized, and the sigmoid sinus is not skeletonized. A linear incision through skin and muscles and use of an abdominal wall fat graft minimize the risk of cerebrospinal fluid leakage.

Conclusions: The exposure provided is sufficient for the majority of tumors in this region and allows for low complication rates.

Keywords: Exoscope; Far lateral; Meningioma; Modified; Skull base.