scholarly journals Resection of an anterior spinal cord AVM through a far-lateral approach

2012 ◽  
Vol 33 (Suppl1) ◽  
pp. 1
Author(s):  
L. Madison Michael ◽  
Jeffrey M. Sorenson
Keyword(s):  
Spinal Cord ◽  
Subarachnoid Hemorrhage ◽  
Arteriovenous Malformation ◽  
Altered Mental Status ◽  
Craniocervical Junction ◽  
Lateral Approach ◽  
Developmentally Delayed ◽  
Stereoscopic Video ◽  
Far Lateral Approach ◽  
Far Lateral

A small arteriovenous malformation near the craniocervical junction with contributions from the anterior spinal artery was discovered in a young developmentally-delayed woman after she presented with altered mental status and evidence of subarachnoid hemorrhage. The malformation could not be completely treated with endovascular therapy, so it was resected through a far-lateral approach. This stereoscopic video demonstrates how to gain the exposure needed to address a lesion in this area. The video can be found here: http://youtu.be/ByjPGm_eXLc.

scholarly journals A far-lateral approach for removal of a C1–2 extradural neurofibroma

2012 ◽  
Vol 33 (Suppl1) ◽  
pp. 1
Author(s):  
Jon H. Robertson ◽  
Jeffrey M. Sorenson
Keyword(s):  
Spinal Cord ◽  
Spinal Canal ◽  
Lateral Approach ◽  
Stereoscopic Video ◽  
Progressive Myelopathy ◽  
Link Type ◽  
Far Lateral Approach ◽  
Type 1 Neurofibromatosis ◽  
Far Lateral

A young man with type 1 neurofibromatosis presented with progressive myelopathy. Imaging revealed an anterolateral mass within the spinal canal at C1–2, with severe compression of the spinal cord. A far-lateral approach was used to remove the mass, which proved to be an extradural neurofibroma. This narrated stereoscopic video details the important steps of the operation. The video can be found here: http://youtu.be/td4MjLtiMbk.

scholarly journals Far Lateral Approach for Resection of Transverse Ligament Cyst

2020 ◽  
Author(s):  
Lattimore Madison Michael ◽  
Vincent Nguyen ◽  
Jaafar Basma ◽  
William Mangham ◽  
Nickalus Khan ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Mass Effect ◽  
Lateral Approach ◽  
Microsurgical Anatomy ◽  
Transverse Ligament ◽  
Far Lateral Approach ◽  
Adequate Understanding ◽  
Far Lateral ◽  
Microsurgical Resection ◽  
Dentate Ligament

Abstract Objectives This study was aimed to describe a far lateral approach for microsurgical resection of a transverse ligament cyst, with emphasis on the microsurgical anatomy and technique. Design A far lateral craniotomy is performed in the lateral decubitus position. After opening the dura laterally, dural sutures are placed for retraction. A stitch placed through the dentate ligament is advantageous to rotate the spinal cord to allow access to the ventral cyst. The cyst is marsupirlized and mass effect on the spinal cord is relieved. Photographs of the region are borrowed from Dr Rhoton's laboratory to illustrate the microsurgical anatomy. Participants The first author performed the surgery and edited the video. Chart review and literature review were performed by the other authors. Outcome Measures Outcome was assessed with postoperative neurological function. Results The patient was discharged home after an uneventful hospital course. At short-term follow-up, the patient had a significant improvement in postoperative strength. Conclusion The far lateral approach provides an adequate corridor to the ventrolateral brainstem in combination with utilization of the dentate ligament to reach ventral cysts compressing the spinal cord. An adequate understanding of the relevant microsurgical anatomy is a key to safe surgery in this region.The link to the video can be found at: https://youtu.be/5MGVPO2Q2pI.

Staged bilateral far-lateral approach for bilateral cervicomedullary junction neurenteric cysts in a 10-year-old girl

2013 ◽  
Vol 12 (3) ◽  
pp. 274-280 ◽  
Author(s):  
Smruti K. Patel ◽  
James K. Liu
Keyword(s):  
Unusual Case ◽  
Pediatric Population ◽  
Craniocervical Junction ◽  
Lateral Approach ◽  
Rare Occurrence ◽  
Benign Lesions ◽  
Far Lateral Approach ◽  
The Central Nervous System ◽  
Far Lateral ◽  
Pontomedullary Junction

Neurenteric cysts are rare and benign lesions that consist of ectopic alimentary tissue residing in the central nervous system. They tend to occur most frequently in an intraspinal rather than intracranial location. Intracranial neurenteric cysts are a rare occurrence in the pediatric population. These lesions typically present as unilateral cystic structures in the lower cerebellopontine angle and craniocervical junction. To the authors' knowledge, there have been no reported cases of bilateral localization of intracranial neurenteric cysts. In this report, they present an unusual case of a 10-year-old girl who was found to have bilateral intracranial neurenteric cysts at the pontomedullary junction. The patient was successfully treated with staged, bilateral far-lateral transcondylar resection of the cysts. The authors also provide a brief overview of the literature describing intracranial neurenteric cysts in children.

scholarly journals Schwannoma of the craniocervical junction: surgical approach of two cases

2003 ◽  
Vol 61 (3A) ◽  
pp. 639-641 ◽  
Author(s):  
Manoel Baldoino Leal Filho ◽  
Guilherme Borges ◽  
Arnaldo Ferreira ◽  
Daniel França ◽  
Patricia Mello
Keyword(s):  
Surgical Technique ◽  
Surgical Approach ◽  
Craniocervical Junction ◽  
Lateral Approach ◽  
Special Focus ◽  
Sitting Position ◽  
Far Lateral Approach ◽  
Far Lateral

We report two cases of craniocervical junction schwannomas with a special focus on the surgical approach. The patients underwent a far-lateral approach in the sitting position that facilitated the lesion removal. This report is meant to improve the understanding of this surgical technique as well as improve awareness of its usefulness for similar cases.

scholarly journals Resection of a Recurrent Cervicomedullary Junction Fibromyxoid Sarcoma through a Far Lateral Approach

2020 ◽  
Author(s):  
Vincent Nguyen ◽  
William Mangham ◽  
Jaafar Basma ◽  
Nickalus Khan ◽  
Jeffrey Sorenson ◽  
...  
Keyword(s):  
Cranial Nerves ◽  
Extent Of Resection ◽  
Craniocervical Junction ◽  
Lateral Approach ◽  
Senior Author ◽  
Microsurgical Anatomy ◽  
Dural Graft ◽  
Far Lateral Approach ◽  
Fibromyxoid Sarcoma ◽  
Far Lateral

Abstract Objectives This study describes a far lateral approach for the resection of a recurrent fibromyxoid sarcoma involving the ventrolateral brainstem, with emphasis on the microsurgical anatomy and technique. Design A far lateral craniotomy is performed in the lateral decubitus position and the transverse and sigmoid sinuses exposed. After opening the dura, sutures are placed to allow gentle mobilization of the sinuses. The recurrent tumor is immediately visible. The involved dura is resected and aggressive internal debulking is performed. Subarachnoid dissection gives access to the lower cranial nerves. The tumor is dissected off the affected portions of the brainstem. A dural graft is used to reconstitute the dura. Photographs of the region are borrowed from Dr. Rhoton's laboratory to illustrate the microsurgical anatomy. Participants The senior author performed the surgery. The video was edited by Dr. V.N. chart review, and literature review were performed by Drs. W.M. and J.B. Outcome measures Outcome was assessed with the extent of resection and postoperative neurological function. Results A near gross total resection of the lesion was achieved. The patient developed a left vocal cord paresis, but her voice was improving at 3-month follow-up. Conclusion Understanding the microsurgical anatomy of the craniocervical junction and ventrolateral brainstem and meticulous microneurosurgical technique are necessary to achieve adequate resection of lesions involving the ventrolateral brainstem. The far lateral approach provides an adequate corridor to this region.The link to the video can be found at: https://youtube/uYEhgPbgrTs.

scholarly journals Retrocondylar Far-Lateral Approach for Resection of a Craniocervical Junction Hemangioblastoma

2019 ◽  
Vol 80 (S 04) ◽  
pp. S349-S351
Author(s):  
Alexander X. Tai ◽  
Kathleen Knudson ◽  
Walter C. Jean
Keyword(s):  
Cystic Lesion ◽  
Craniocervical Junction ◽  
Lateral Approach ◽  
Total Resection ◽  
Operative Strategy ◽  
Postoperative Course ◽  
Suboccipital Craniectomy ◽  
Far Lateral Approach ◽  
Far Lateral ◽  
Neurologically Intact

AbstractWe present a case in which a retrocondylar far-lateral approach was utilized to resect a hemangioblastoma at the craniocervical junction. The patient was a 33-year-old man presenting with 2 months of symptoms referable to compression at the craniocervical junction (i.e., dizziness and gait instability). Though neurologically intact on exam, his imaging demonstrated a highly vascular cystic lesion dorsolateral to the medulla on the left consistent with a hemangioblastoma. Virtual reality software was critical to visualize the patient's lesion in relationship to the vertebral artery and draining vein (Fig. 1). A far-lateral retrocondylar suboccipital craniectomy with a C1 hemilamiectomy permitted resection of this lesion. The operative strategy was to address the lesion similar to an arteriovenous malformation by detaching the lesion from its arterial feeders first, and then addressing the lesion's draining vein (Fig. 2). Postoperative imaging demonstrated a gross-total resection and the patient had an uncomplicated postoperative course. This case demonstrates not only the lateral reach of a retrocondylar far-lateral approach; but also, clearly demonstrates an effective dissection strategy when approaching a hemangioblastoma.The link to the video can be found at: https://youtu.be/M0szMOdhjfE.

scholarly journals Far Lateral Approach for Disconnection of Craniocervical Junction Dural Arteriovenous Fistula Presented with Myelopathy and Hydrocephalus

2020 ◽  
Author(s):  
Siu Kei Samuel Lam ◽  
Sai Lok Chu ◽  
Shing Chau Yuen ◽  
Kwong Yui Yam
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Hybrid Approach ◽  
Normal Pressure ◽  
Craniocervical Junction ◽  
Lateral Approach ◽  
External Carotid Artery ◽  
External Carotid ◽  
Far Lateral Approach ◽  
Far Lateral

AbstractWe report a case of craniocervical junction dural arteriovenous fistula (dAVF) presented with myelopathy and normal pressure hydrocephalus, and was treated with hybrid approach of embolization and surgical disconnection. A 68-year-old gentleman presented with 1 year history of unsteady gait and sphincter disturbance. Magnetic resonance imaging (MRI) showed abnormally enlarged and tortuous vessels over right cerebellomedullary cistern. Digital subtraction angiogram (DSA) showed Cognard's type-V dAVF at craniocervical junction. Catheter embolization was performed via external carotid artery and finally surgical disconnection was done with far lateral approach (Fig. 1). Postoperative DSA showed no more arteriovenous shunting (Fig. 2). Clinically the patient improved after a course of rehabilitation. Dural AVF at craniocervical junction is rare and its clinical presentation can be highly variable from subarachnoid hemorrhage to brainstem dysfunction. Identification of the exact fistula site is essential in surgical planning. Surgery is effective and safe to achieve complete obliteration and good clinical outcome.1 2 3 4 5 6 The link to the video can be found at: https://youtu.be/xI48stSlWpY.

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