Successful resection of anterior and anterolateral lesions at the craniovertebral junction using a simple posterolateral approach

Kshettry, Varun R.; Chotai, Silky; Hou, Jack; Lamki, Tariq; Ammirati, Mario

doi:10.1016/j.jocn.2013.06.010

Cited by 12 publications

(10 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This approach is used also to remove the petrous part of temporal bone in different degrees for reaching the clival region. Lateral approaches include translabirynthine, transcochlear and anterior transpetrousal approaches [22], extreme lateral, far lateral [23], transfacetal, partial transcondylar, complete transcondylar, extreme-lateral transjugular and transtubercular approaches with or without division of the sigmoid sinus [3]. Extreme lateral approach provides access to lesions in the middle of the FM [24,25,15].…”

Section: Lateral Approachmentioning

confidence: 99%

See 1 more Smart Citation

Morphological Analysis of Occipital Condyles and Foramen Magnum as a Guide for Lateral Surgical Approaches

Ilhan

Kayhan

Erturk

et al. 2017

MOJAP

View full text Add to dashboard Cite

Section: Lateral Approachmentioning

confidence: 99%

“…It has several advantages-there is no need for drilling the OCs or lateral mass, and postoperative recovery is fast [27]. This approach can be divided into posterior suboccipital, posterolateral (lateral suboccipital), far lateral [23], standard para median suboccipital and transcondylar approaches [28,29].…”

Section: Posterior Approachmentioning

confidence: 99%

Morphological Analysis of Occipital Condyles and Foramen Magnum as a Guide for Lateral Surgical Approaches

Ilhan

Kayhan

Erturk

et al. 2017

MOJAP

View full text Add to dashboard Cite

“…This, in fact, has been demonstrated in prior clinical series (1,3). It is emphasized that Anichini et al only evaluated qualitative exposure as the primary end point.…”

Section: Selecting the Optimal Surgical Approachmentioning

confidence: 82%

Endoscopic-Assisted Techniques at the Craniovertebral Junction: Understanding Indications and Limitations

Kshettry

Benzel

2014

World Neurosurgery

Self Cite

View full text Add to dashboard Cite

“…However, in an attempt to avoid iatrogenic instability requiring OC fusion, many surgeons perform condylectomy sparing the OC joint. 18,19,39 We hypothesized that a joint-sparing technique would result in added stability at this degree of condyle resection.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical evaluation of the craniovertebral junction after unilateral joint-sparing condylectomy: implications for the far lateral approach revisited

Kshettry

Healy

Colbrunn

et al. 2017

Journal of Neurosurgery

Self Cite

View full text Add to dashboard Cite

OBJECTIVE The far lateral transcondylar approach to the ventral foramen magnum requires partial resection of the occipital condyle. Early biomechanical studies suggest that occipitocervical (OC) fusion should be considered if 50% of the condyle is resected. In clinical practice, however, a joint-sparing condylectomy has often been employed without the need for OC fusion. The biomechanics of the joint-sparing technique have not been reported. Authors of the present study hypothesized that the clinically relevant joint-sparing condylectomy would result in added stability of the craniovertebral junction as compared with earlier reports. METHODS Multidirectional in vitro flexibility tests were performed using a robotic spine-testing system on 7 fresh cadaveric spines to assess the effect of sequential unilateral joint-sparing condylectomy (25%, 50%, 75%, 100%) in comparison with the intact state by using cardinal direction and coupled moments combined with a simulated head weight "follower load." RESULTS The percent change in range of motion following sequential condylectomy as compared with the intact state was 5.2%, 8.1%, 12.0%, and 27.5% in flexion-extension (FE); 8.4%, 14.7%, 39.1%, and 80.2% in lateral bending (LB); and 24.4%, 31.5%, 49.9%, and 141.1% in axial rotation (AR). Only values at 100% condylectomy were statistically significant (p < 0.05). With coupled motions, however, -3.9%, 6.6%, 35.8%, and 142.4% increases in AR+F and 27.3%, 32.7%, 77.5%, and 175.5% increases in AR+E were found. Values for 75% and 100% condyle resection were statistically significant in AR+E. CONCLUSIONS When tested in the traditional cardinal directions, a 50% joint-sparing condylectomy did not significantly increase motion. However, removing 75% of the condyle may necessitate fusion, as a statistically significant increase in motion was found when E was coupled with AR. Clinical correlation is ultimately needed to determine the need for OC fusion.

show abstract

Successful resection of anterior and anterolateral lesions at the craniovertebral junction using a simple posterolateral approach

Cited by 12 publications

References 42 publications

Morphological Analysis of Occipital Condyles and Foramen Magnum as a Guide for Lateral Surgical Approaches

Morphological Analysis of Occipital Condyles and Foramen Magnum as a Guide for Lateral Surgical Approaches

Endoscopic-Assisted Techniques at the Craniovertebral Junction: Understanding Indications and Limitations

Biomechanical evaluation of the craniovertebral junction after unilateral joint-sparing condylectomy: implications for the far lateral approach revisited

Contact Info

Product

Resources

About