The transcondylar approach to extradural nonneoplastic lesions of the craniovertebral junction

Journal of Neurosurgery
Ossama Al-MeftyT G Pait

Abstract

Ventral extradural lesions at the craniovertebral junction are commonly exposed through the transoral or transmaxillary approach. The disadvantages of these approaches include: 1) difficulty in reaching laterally located lesions; 2) ineligibility of patients with an intradental distance of less than 25 mm or severe macroglossia; 3) the need for a separate procedure for stabilization and fusion; and 4) the risk of infection from transgressing a contaminated field. In this report, the authors describe the use of the transcondylar approach to extradural nonneoplastic lesions of the anterior craniovertebral junction for decompression and stabilization. Advantages of this approach include: 1) a short distance to the lesion; 2) a wide surgical envelope; 3) direct visualization of the dural sac, eliminating manipulation of the brainstem or upper spinal cord; 4) easy identification and control of the ipsilateral vertebral artery; 5) direct visualization and preservation of the lower cranial nerves; and 6) a sterile field. In addition, occipitocervical fusion and instrumentation can be performed during the same procedure. The transcondylar approach, based on anatomical studies in cadavers, was used to treat eight patients with ventral n...Continue Reading

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Citations

Jan 17, 2009·Surgical and Radiologic Anatomy : SRA·Aykut KarasuOssama Al-Mefty
May 1, 2009·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Homère MouchatyNicola Di Lorenzo
Mar 12, 2008·Skull Base : Official Journal of North American Skull Base Society ... [et Al.]·Masashi TamakiKikuo Ohno
Mar 27, 2003·Neurosurgery·Uğur TüreM Necmettin Pamir
Mar 5, 2010·Neurosurgery·Youssef R KaramVincent C Traynelis
Dec 11, 2002·Neurologia Medico-chirurgica·Elio Arnaldo Marin SanabriaNorihiko Tamaki
Mar 28, 2006·Neurologia Medico-chirurgica·Carsten StüerCarlo Schaller
Jun 1, 2006·Neurosurgical Focus·N TamakiK K Barua
Feb 1, 1997·Journal of Neurosurgery·O al-Mefty, L A Borba
Feb 1, 1997·Journal of Neurosurgery·K I ArnautovićM M Husain
Jan 1, 2000·Journal of Neurosurgery·J R VenderD E McDonnell
Jan 25, 2002·Journal of Neurosurgery·Uğur Türe, M Necmettin Pamir
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Jul 30, 2014·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Mohamed Ali El-GaidiEhab A A El-Shaarawy
Nov 30, 2012·Neurosurgical Review·Fuminari KomatsuManfred Tschabitscher
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Mar 10, 2007·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Kadir Kotil

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